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2012 ATTENDEE REGISTRATION

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attendee Information
 
Name:

First Name

Last Name
Company Name:
Work Address: 
 
City State Zip
Telephone Number:
Fax Number:
Email Address:
Alternate Email Address:
Your Name to appear on badge:
Member Information
Yes, I am an active member of: FWEA/WEF FSAWWA/AWWA FW&PCOA
Please contact me regarding membership in: FWEA/WEF FSAWWA/AWWA FW&PCOA

Occupation  
(please check one)
:
Manufacturer
Sales Representative
Operator
Consultant
Management
Young Prof.
Other

FULL CONFERENCE REGISTRATION
(APRIL 29-MAY 2, 2012)
PRICESUBTOTAL
Includes: Daily Receptions, Technical Sessions, Exhibits, Workshops each day, Monday Awards Luncheon, Proceedings, & Eligibility for Daily Drawings. Earns 0.1 CEUs or 1 PDH at Technical Sessions & Workshops as approved.
Member/ Utility/ State Employee
Non-Member
Spouse
Retired Member
1-DAY-ONLY CONFERENCE REGISTRATIONPRICESUBTOTAL
Includes: Daily Reception, Technical Sessions, Exhibits, 2 Workshops, and Daily Luncheon, Proceedings, & Eligibility for Daily Drawings. Earns 0.1 CEUs or 1 PDH at Technical Sessions & Workshops as approved.
1-Day Monday Registration, includes lunch - Select two (2) Workshops from below
1-Day Tuesday Registration, includes lunch Select Two (2) Workshops from below
1-Day Speaker
1-Day Contest Participants, includes lunch
1-Day Student
MONDAY WORKSHOP SELECTION: 0.1 CEU PER 1 CLASS HOUR (AS APPROVED)PRICESUBTOTAL
Select 2 Workshops on Monday (D1 and E1 are AM classes, D6 and E6 are PM classes). Earns 0.1 CEUs or 1 PDH at Technical Sessions & Workshops as approved.
D1 -
E1 - Mobile Technology: Delivering GIS to Staff
F1 - Potable ASR Projects: Construction to Cycle Testing
D6 - Contractors Council Forum
E6 -Understanding Your Collection System Assets
F6 - Emerging Issues Facing Potable Distribution Systems
TUESDAY WORKSHOP SELECTION: 0.1 CEU PER 1 CLASS HOUR (AS APPROVED)PRICESUBTOTAL
Select 2 Workshops on Monday (D11 and E11 are AM classes, D16 and E16 are PM classes). Earns 0.1 CEUs or 1 PDH at Technical Sessions & Workshops as approved.
D11 -
E11 - AMr/AMI - Best Practices and Success Stories
F11 - Everything Old Is New Again: Integrating Onsite Alt. Water Supplies
D16 - Reuse Roundtable
E16 - Numeric Nutrient Criteria: What it Means to Your Utility
F16 - Protecting Your Utility's Assets: What You Need to Know
ANNUAL GOLF TOURNAMENTPRICESUBTOTAL
Check all items needed
One Golf Foursome
Team of 4 w/ one Hole Spnsr
Golf Door Prizes
W2 Individual Golf
SPECIAL EVENTS & MEAL TICKETSPRICESUBTOTAL
M1 FSSSSS Member Breakfast
M3 FWRC Awards Luncheon
T5 FSAWWA Reg Chairs & Volunteers Breakfast
T6 FWEA Awards Luncheon & Annual Meeting
W7 Utility Council Ann Mtg Breakfast
Other Association Meetings
TOTAL:
Check Here if you wish to earn, and where to apply credits:
Professional Engineer License #:
Wastewater License #:
Water License #:
Other License #:
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Cancellation Policy
Written cancellation is required and must be received no later than APRIL 1, 2012.
A $25 handling fee will apply. Allow 6 weeks for processing.

Registration must have both form and fee remitted to be accepted. Confirmation will be mailed to you upon processing.





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