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Water Upon Request Interest Form

Fill out this form to order program materials and menu snipes for your restaurant.

Business Information

Restaurant Name

Contact Name

Address 1

Address 2 (Optional)

City

State

Postal Code

Email

Confirm Email

Program Assets

English Menu Snipes

Menu Snipes Quantity

Color
Spanish Menu Snipes

Menu Snipes Quantity

Color
Water Upon Request Table Tents

Quantity
Water Upon Request Check Inserts

Quantity
Water Upon Request Pens

Quantity

Delivery Information

Physical Assets

My mailing address is the same as my business address.

Address 1

Address 2 (Optional)

City

State

Postal Code

Digital Assets

Enter an email address if you would like to receive digital assets, including the Water Upon Request logo, a customizable table tent, etc.

My email address is the same as above.

Email

Confirm Email

Agreement

As a restaurant participating in the Water Upon Request program, we agree to serve water only when it is requested.