Your Information

Please fill out your information below to start the online course.

First Name *

Last Name *

Address *

Address 2

City *

State *

Zip *

Phone *

E-Mail Address *

Participating Community *

Please select ONE of the two options below to receive your voucher once your successful completion of the quiz and the location of your residence has been verified.

I would like to receive my voucher by means of the email address provided above. I am able to print my own voucher.

I would like to receive my printed voucher by postal mail at the address given above.

I understand that I will need to submit my printed voucher to receive a rebate from Franklin Soil and Water or one of the Local Vendors offering immediate discounts.

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