Conservation Kit Request Form

Conservation Kit Request Form

After your request is reviewed (allow up to 3 business days), a voucher will be sent to your email. This offer is limited to one kit per household and is only available to Glendale water customers while supplies last. Glendale Water Services is not liable for the installation, maintenance, or use of these items. Questions? Contact Litzy Hernandez Cota at lcota@glendaleaz.com or call 623.930.3535.
How did you learn about the conservation kits? (Select all that apply.)*

Bill InsertSocial MediaE-Newsletter2025 Clean and Green CalendarNextDoorWebsiteLocal EventsWord of Mouth (from a friend, neighbor, or family member)Other
If you selected "Other" for the question above, please specify.
Did you complete the online water use calculator? It's easy! Enter a few pieces of information about your household’s water use habits to receive an estimate of how much water you need. Visit: amwua.org/water-use-calculator*

YesNo
Glendale Water Account Number (If you don't know where to find your account number, go to bit.ly/glendaleazwateraccount):*
Multi-family customers must obtain the water account number from their property manager or leasing office. If you need assistance, please contact Litzy Hernandez Cota at lcota@glendaleaz.com or 623-930-3535.
Water Account Holder:*

First NameLast Name
Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Property Type:*

Single-familyMulti-family (apartment, condo, or townhouse)
Phone Number:*
Please enter a valid phone number.
Email:*
example@example.com
I'll pick up my kit at the:*

Main Library (5959 W Brown St.)Foothills Library (19055 N 57th Ave)Velma Teague Library (7010 N 58th Ave)Heroes Regional Park Library (6075 N 83rd Ave)
The Water Services Department - Conservation & Sustainable Living Division provides additional programs for residential customers. Are there programs where you would like to receive additional information? (Select all that apply.)

Water-efficiency ClassesGrass Removal Landscape RebateLandscape ConsultationsGlendale Xeriscape Demonstration GardenGarden Volunteer WorkdaysMonthly newsletter with water-efficiency tipsNo, I already know about these programs.No, I'm not interested at this time.
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