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IED Portal

An Official Pennsylvania Government Website

Department of Environmental Protection

DEP

Online Participation Form
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Requestor Information

Required fields are marked with an asterisk.(*)
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First Name

**

Last Name

**

Email

***

Confirm Email

***

Phone Number (XXX-XXX-XXXX)

*

Organizational Affiliation, if Applicable

*

County of Residence

*

DEP Regions of Interest (choose all that apply)*

Northeast Region

North-central Region

Northwest Region

Southeast Region

South-central Region

Southwest Region

Topics of Interest (choose all that apply)

Air Quality

Water

Land

Energy

Department-Wide Issues

Other

Please Describe Other

*

Preferred Availability to Attend a DEP Meeting (choose all that apply)

Weekday Morning

Weekday Afternoon

Weekday Evening

Weekend

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