WaterSmart Home Toilet Program Application Form - Barwon Water

WaterSmart Home Toilet Program Application Form

Applicant information
I have read the Terms and Conditions of the Program *
Do you live at the property? *

Toilet information
Type of toilet cistern upgrade you are applying for (please tick) *

Supporting documentation

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Declaration
I confirm that the details contained in this application form are current and by applying, I agree to the Terms & Conditions and that Barwon Water’s contract plumber can contact me to arrange a suitable time to complete the toilet cistern upgrade.
    Date *

    Privacy Statement

    We’re committed to protecting your privacy. We are required to comply with the Privacy and Data Protection Act 2014 and other laws relating to the protection of personal information.

    We collect personal information for the purpose of providing water and sewerage related services and products. The personal information we collect will not be used or disclosed for any other purpose without your consent, unless permitted under privacy legislation. We do not sell, rent, trade, or otherwise make available customers’ personal information.

    Information that you provide on the application form will be used by Barwon Water to assess whether the application meets the eligibility criteria for a toilet cistern upgrade and will be checked against Barwon Water customer account details for assessment purposes. Your contact details will be provided to Barwon Water’s contract plumber so they can arrange a suitable time to complete the plumbing works.

    More information about protecting your privacy