Home Address
Town/Village
Country*	Israel Jordan

Note The following information is being collected for research on gray water treatment only. It will not be sold nor given away for commercial or any other purpose. Moreover, it will not include any personal information (first name, last name, email address). By providing the information below, we will assume you approve of its use for the purpose stated (research).

Marital Status	Single Married
Age Range	19 or below 20 - 34 35 - 49 50 - 64 65 or above
Gender	Female Male
Household Size
Children	None 1 2 3 4 5 or More	Adults	1 2 3 4 or More
H.S. Diploma	Yes No
Gray Water System Type	Subsurface Flow Upflow Gravel Vertical Green Wall