Form Center

2. How much of a problem do you think pet waste poses for water quality?

   1. Not a Problem
   2. Minor Problem
   3. Major Problem
   4. Not Sure
4. How often should pet waste in your yard be picked up?

   1. Every Day
   2. A Few Times a Week
   3. A Few Times a Month
   4. Rarely
   5. Never
6. What do you think would motivate pet owners to pick up and dispose of dog waste properly?

   1. Bag Dispensers in Public Areas
   2. Education About Importance of Proper Disposal
   3. Fines
   4. Handy Trash Cans
   5. Other
8. If "Other", what is your idea to motivate pet owners to pick up and dispose of pet waste?
10. How concerned are you about pollution in creeks, streams, and other waterways in the Winston-Salem area?

    1. Very Concerned
    2. Somewhat Concerned
    3. Not Concerned
    4. Not Sure
12. What do you think that the water quality in creeks, streams, and other waterways in Winston-Salem?

    1. It's getting much better
    2. It's getting somewhat better
    3. It's about the same as ever
    4. It's getting worse
    5. Not sure
14. Which of the following do you think contributes the most pollution to creeks, streams, and other waterways in Winston-Salem?

    1. Factories and Industry
    2. Sewage Overflows
    3. Stormwater Runoff
    4. Wastewater Treatment Plant
16. Do you think that you can personally do anything to help improve water quality in creeks, streams, and other waterways in the Winston-Salem area?

    1. Yes
    2. No
    3. Not Sure
18. Please tell us your 5-digit ZIP code:*
Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field