Drain Ranger Badge Form

2. Howdy Drain Ranger!
   We hope you've learned about water pollution and that you will share it with your friends and family. Please tell your friends about Dewey and how they can be Drain Rangers, too! <BR><BR>To receive your Drain Ranger badge, please provide us with the following information. This information will not be kept or used for any purpose other than mailing you a Drain Ranger badge.

   We hope you've learned about water pollution and that you will share it with your friends and family. Please tell your friends about Dewey and how they can be Drain Rangers, too!
   
   To receive your Drain Ranger badge, please provide us with the following information. This information will not be kept or used for any purpose other than mailing you a Drain Ranger badge.

4. Name

6. Mailing Address

8. City

9. State

10. Zip

12. Phone or Email

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14. 1. Receive an email copy of this form.
15. Email address

    This field is not part of the form submission.

16. Submit

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