Southwest Membrane Operator Association

Yes, I want to join the Southwest Membrane Operator Association

Name:

Title:

Company:

Mailing Address:

City: State:

Zip Code:

Phone (999-999-9999):

Cell Phone (999-999-9999):

Fax:

E-mail:

Would you be interested in serving as a SWMOA Board Member:

Would you be interested in presenting at a SWMOA Symposium, Workshop, or MOC School:

Division 1
A. Public Agencies, Industrial Users and Water Suppliers	$300.00
B. Operator Individual Membership	$ 50.00
If Certified, please provide Certification Number:
(Division 1B members please fax a copy of your certificate to: 772-463-0860)

Division 2
A. Manufactures, Suppliers, and Consulting Firms	$400.00
B. Small Firms (fewer than 5 persons)	$200.00

Division 3
A. Affiliate of Division 1A (not an Operator)	$ 75.00
B. Affiliate of Division 2	$100.00
C. Interested Individuals (not affiliated with any organization)	$125.00
D. Full-Time Student/Intern (must submit proof along with application)	$ 25.00

SWMOA Membership is based on an annual membership from January 1 - December 31 each year. However, if an application is received after October 1, membership benefits shall extend to the end of the following calendar year.

Committee Preferences:

Payment Instructions:
Payable to: Southwest Membrane Operator Association, 1035 E. Vista Way #103, Vista, CA 92084

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