6100-17 Awards Application Manufacturer

2009

OMB Control Number 2040-0272
Approval Expires 01/31/2010

WaterSense® Awards

Instructions

The U.S. Environmental Protection Agency’s WaterSense program is pleased to recognize the
accomplishments of its partners. Partners in each category contribute to our shared mission of
protecting the future of our nation’s water supply by promoting water-efficient products, services, and
practices.
To apply for a WaterSense award, please complete the following steps:
1. Ensure Eligibility. To be eligible for an award, you must have become a WaterSense partner
prior to January 1, 2009. In addition, you must have submitted your 2009 WaterSense annual
reporting form.
2. Complete the Awards Application Form. Please fill out the brief application form, including
your contact information, eligibility confirmation, and a description of your organization.
3. Compose a Written Statement. Please prepare a short, written statement that addresses each
of the evaluation criteria for your award category. Your written statement must be no more
than five (5) pages in length. (Please organize and label your responses to coincide with the
evaluation criteria categories). Your responses should address WaterSense-related efforts and
accomplishments that you conducted in 2008.
4. Compile Supporting Materials. Please include sample or supporting materials that clearly
demonstrate how your organization has supported the WaterSense program mission. The
materials should complement your written statement and provide WaterSense with tangible
examples of your outreach activities. Please refer to the category-specific instructions for your
sector for a list of examples.
5. Submit Two (2) Copies of the Complete Award Application Package. Mail two (2) copies
of your complete application package, including the application form, written statement, and
sample or supporting materials to:
WaterSense
c/o ERG
2300 Wilson Blvd., Suite 350
Arlington, VA 22201
Your application package must be postmarked no later than April 10, 2009.
If you have questions, please contact the WaterSense Helpline by e-mail at watersense@epa.gov or
by calling toll free: (866) WTR-SENS (987-7367).
The public reporting and recordkeeping burden for information collection requirements associated with the awards application for each respondent is estimated to
be 21 hours. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing
respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency
(2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

(866) WTR-SENS (987-7367) · www.epa.gov/watersense · watersense@epa.gov

2009

OMB Control Number 2040-0272
Approval Expires 01/31/2010

WaterSense® Awards

Manufacturer Partner of the Year Application

Organization Name: _____________________________________________________________________
Number of Employees: ___________________________________________________________________
Number of Products or Models: ____________________________________________________________
Contact Name: _________________________________________________________________________
Contact Title: ___________________________________________________________________________
Contact Phone: __________________ Fax: _________________ E-mail: ___________________________
1. Please verify your eligibility:
❏ Joined WaterSense partnership prior to January 1, 2009?

Date joined:_________________

❏ Submitted 2009 annual reporting form?

Date submitted: _____________

2. Please provide a brief description (no more than 300 words) about your organization. If you are
selected to receive an award, this text will be the basis for describing your organization in award
recognition materials. Attach an additional page if necessary.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
3. To complete the application process, carefully
review the written statement instructions
and evaluation criteria, prepare your written
statement, and submit your complete
application package by April 10, 2009.

EPA Form Number 6100-17.

Important Dates
Annual reporting form deadline: March 2, 2009
Application deadline: April 10, 2009
Award winner notification: June 19, 2009
Recognition ceremony: October 7-9, 2009

(866) WTR-SENS (987-7367) · www.epa.gov/watersense · watersense@epa.gov

Written Statement Instructions
Please compose your written statement by addressing each of the following evaluation criteria based
on your activities in 2008. Organize and label your statement using the categories listed below (e.g.,
“Labeled Products in the Marketplace”). In total, your written statement must be no more than five (5)
pages in length, not including sample or supporting materials.
To strengthen your application:
•

Include measurable results wherever possible. For manufacturer partners, this might include the
total number of product models that have received the label, number of places you use the
WaterSense marks, number of media hits, value of media impressions, or number of markets in
which consumers can find your labeled products.

•

Include sample materials in your application package to thoroughly demonstrate your
accomplishments. For manufacturer partners, these materials might include sample marketing
materials (e.g., brochures, specification sheets), photographs of products or packaging displaying
the WaterSense label, print and broadcast advertisements, or samples of print and broadcast
media, for example.

•

Organize your written statement to address the evaluation criteria and avoid double counting
your activities across categories.

WaterSense will evaluate your application based on your written statement in response to the criteria
below. The point values following each category indicate the maximum potential value for all activities
within that category.

Evaluation Criteria
1. Labeled Products in the Marketplace (40 points)
•

Identify the number and types of WaterSense labeled products your organization brought to
market. Include the percentage of your portfolio that has earned the WaterSense label and the
number and/or percentage of markets in which your WaterSense labeled products are sold.

•

Describe your organization’s innovations in water-efficient design that were brought to
market in 2008.

2. Promotion and Public Relations Activities (30 points)
•

Describe your organization’s efforts to promote WaterSense in print and broadcast media.
Highlight how you used the WaterSense name or marks and quantify results, such as number
of media impressions, direct mail pieces, or Web page views (if possible).

•

Describe how your organization is promoting WaterSense labeled products to the public,
including consumers, trade organizations, and other relevant audiences. Show samples and
list the results of your efforts.

•

Describe and provide examples of how your organization has promoted your partnership with
WaterSense on your Web site and in other external (customer focused) and internal (employee
focused) mediums.

3. Use and Visibility of WaterSense Marks (20 points)
•

Describe how and where your organization has used the WaterSense marks to promote the
WaterSense program, your WaterSense partner status, and/or your labeled products.

4. Strategic Collaboration (10 points)
•

Describe how your organization has collaborated with retailers, promotional partners (e.g.,
utilities, nonprofits, trade associations, state and local governments), or other manufacturers
to further a common goal of increased water efficiency. Provide quantifiable results, if possible,
and describe how this collaboration relates to the WaterSense mission.