2. Reserve a Water Drop Box for your classroom
   *Loan periods are for two school weeks. *We will do our best to deliver your Water Drop Box as close to your requested date as possible, then pick it up on the last day of the reservation. *If a Water Drop Box is unavailable during your requested time, we will contact you with other possible dates. *Water Drop Boxes are currently available for delivery in Athens-Clarke County only. *Only one Water Drop Box may be checked out by a classroom during a two week period.
3. First Name*
4. Last Name*
6. School or Organization Name*
7. Contact Number*
8. Address *
10. E-mail*
12. Preferred Start Date*
    Preferred Start Date
13. Preferred End Date*
    Preferred End Date
15. 2nd Choice Start Date
    2nd Choice Start Date
16. 2nd Choice End Date
    2nd Choice End Date
18. Grade or Age of Students*
19. Total # of Students to Use Water Drop Box
21. Which Water Drop Theme are you requesting? *

    Select one

    1. Water Concentration Games
    2. Water Conservation
    3. Water Cycle
23. In the event your theme selection is unavailable, would you like to request a second choice?

    Select one

    1. Water Concentration Games
    2. Water Conservation
    3. Water Cycle
25. How did you learn about the Water Drop Boxes?
26. Additional information you would like to include?
28. Thank you for your interest in the Water Drop Boxes!
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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field