Water Tips and Facts

The majority of households in 60 of Virginia's 95 counties rely on private water supply systems.

Virginia Well Owner Network Volunteer Application

Click here to download the paper application

Applicant Information:

First Name:

Last Name:

Date:

Street Address:

City:

State:

Zip:

Phone Number:

Email Address:

County:

Gender:

Date of Birth:

Occupation:

Questions in this section are for Virginia Cooperative Extension record-keeping purposes

I live:

Gender:

Race:

Program Interest

Do you own or work at a business associated with private water systems (i.e. well drilling, water treatment, etc.)?

If yes, please describe the business:

Do you own a private water well, spring or cistern and depend on it for the water supply to your primary home, vacation home, or camp?

Are you interested in (please select one):

Learning more about your own water quality, system construction, care and maintenance, and solving water problems and NOT serving as a volunteer with our volunteer program.

Learning about your own water quality and system AND serving as a Well Owner Network Volunteer? Serving as a Well Owner Volunteer means that you will agree to have your contact information posted on our website, receive emailed questions from Virginia citizens, and assist local Extension agents as possible with conducting drinking water clinics and other outreach events.

Would you prefer a face to face training workshop (about 8 hours) or a series of online modules? Note: there may be a small charge for face-to-face training workshops.

Face-to-face training workshop

Online training modules

Volunteer agreement: I am volunteering my time to further the educational purposes of Virginia Cooperative Extension and will abide by the policies and procedures therof. I will not discriminate on the basis of race, color, reed, religion,sex, national origin, handicap, or political affiliation.

By clicking submit I acknowledge that I have read and understand the Virginia Well Owner Network volunteer expectations and policy.

Thank you for your interest. You will be notified within two weeks if you have been selected to participate. If you have any questions feel free to contact the coordinator.