Fields marked with are compulsory Please complete the form below to request for NEWater canisters and dispensers. Name of Organisation: Type of organisation ---Select Organisation--- Pre-Schools Primary Schools Secondary Schools Tertiary Institutions Grassroots Organisations Corporates Public Agencies Non - Governmental Organisations / Interest Groups Others Name of Requester: Contact Number Email: Name of Event Start Date of Event 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2024 2025 2026 2027 2028 2029 Date must be 10 working days later than the current date End Date of Event 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2024 Date must be later than the Start date Event Venue Synopsis of event No. of Participants: Help us promote the importance of water through one of the following ways: Promotional Activities #1 ---Select Promotional Activity #1--- Display poster on water saving tips Display info panels on NEWater (subject to availability) Screen water-related video clips Conduct water-related quizzes Speech by GOH dedicated to water issues Sign up event participants for NEWater Visitor Centre tours Other suggestions Promotional Activities #2 ---Select Promotional Activity #2--- Display poster on water saving tips Display info panels on NEWater (subject to availability) Screen water-related video clips Conduct water-related quizzes Speech by GOH dedicated to water issues Sign up event participants for NEWater Visitor Centre tours Other suggestions Preferred Date & Time of Delivery of canisters and dispensers 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2024 Prefered Date must be later than the current date Time --Select-- 12:00 AM 1:00 AM 2:00 AM 3:00 AM 4:00 AM 5:00 AM 6:00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM 6:00 PM 7:00 PM 8:00 PM 9:00 PM 10:00 PM 11:00 PM Date must be later than the current date Preferred Date & Time of Return of canisters and dispensers 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2024 Prefered Return Date must be later than the Prefered Delivery date Time --Select-- 12:00 AM 1:00 AM 2:00 AM 3:00 AM 4:00 AM 5:00 AM 6:00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM 6:00 PM 7:00 PM 8:00 PM 9:00 PM 10:00 PM 11:00 PM Date must be later than the current date Name(s) & Mobile Number(s): Contact Name 1 Contact Number 1 Contact Name 2 Contact Number 2 Contact Name 3 Contact Number 3 Verification Code SUBMIT
