APPENDIX C

CITY OF COLD SPRING STORMWATER PROGRAM

ANNUAL STORMWATER EDUCATION CREDIT APPLICATION

DUE MAY 1

School: ___________________________________________________________________________________________

Contact name: _____________________________________________________________________________________

Address: __________________________________________________________________________________________

Phone #: ____________________________________ Email: _______________________________________________

# of Staff: ____________________________________ # of Students: ________________________________________

A) Twenty percent of students will participate in water quality in-service program. Please list:

 

Name	Grade/ subject	Contact number	Email

 

Attach additional information as needed.

__________________________________________         ____________________________

School administrator                        Date

Approved:

__________________________________________         ____________________________

City of Cold Spring                        Date

 

Please return completed form to:         City of Cold Spring                      Stormwater Program TAC                      City of Cold Spring                      5694 East Alexandria Pike Deadline for submission is May 1         Cold Spring, KY 41076 www.coldspringky.com/stormwater_credits.html   Phone: [phone]

 

(Ord. 14-1003, passed 5-12-14)