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County Fair Raffle
County Fair Raffle
Raffle Form
Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Date
(Required)
Month
Day
Year
Are you a Bedford Regional Water Authority customer?
(Required)
Yes
No
Are you satisfied with Bedford Regional Water Authority's customer service?
(Required)
Highly Satisfied
Satisfied
Neutral
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Highly Dissatisfied
Are you satisfied with Bedford Regional Water Authority's water services?
(Required)
Highly Satisfied
Satisfied
Neutral
Dissatisfied
Highly Dissatisfied
How likely are you to share a positive/negative Bedford Regional Water Authority experience with a friend?
(Required)
Very Likely
Likely
Neutral
Unlikely
Very Unlikely
Do you have any suggestions that could help Bedford Regional Water Authority improve?
To participate in this raffle, you must be 18 or older.
(Required)
I am at least 18
I am under the age of 18
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