Application to Partner with Water from Wine

Application to join Water from Wine's private label program

RECEIVE DONATIONS THROUGH WINE SALES
CONTACT INFORMATION
Full Legal Organization Name
Organization Website
EIN
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Point of Contact #1

First Name Last Name
Title
Phone Number
Please enter a valid phone number.
E-Mail Address
example@example.com
Point of Contact #2

First Name Last Name
Title
Phone Number
Please enter a valid phone number.
E-Mail Address

PROJECT INFORMATION
Types of water & sanitation projects implemented (ex. borehole, piped water, rainwater catchment, etc and/or toilets/latrines):
Country/location of projects
COMMUNITY ENGAGEMENT
Please describe the type of community engagement expected for each project:
Do you hire community members as part of project implementation? If yes, are these permanent or temporary positions?

SUSTAINABILITY
Please state your goals surrounding the sustainability of your water projects, and how those goals are monitored and achieved:
ADDITIONAL INFORMATION
Is there anything else you'd like us to know about your organization?

Application to join Water from Wine's private label program