Membership Application To apply for membership, fill out and submit the form below, or download a printable application form that you print, fill out and mail. Primary MemberSalutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast Name*SuffixJob Title* Organization & AddressOrganization*Mailing Address*City*State/ProvinceZIP/Postal CodeCountry* Contact InformationTelephone*Cell PhoneFaxEmail Address* Email Notifications*Yes, I authorize receiving publication email notificationsNo, I would not like to receive publication email notifications (opt-out)Authorization for receiving publication email notification from SWMOA.(applies to all email addresses on this form)Website Volunteer OpportunitiesCommittee Preferences Audit/Finance Awards Bylaws/Policies Legislative Membership Nominations/Election Operator Certification Publications/Newsletter Program/Technology Transfer Public Relations Other Interests I am interested in running for a position on the SWMOA Board of Directors. I am interested in presenting at a Symposium, Workshop, or hosting an event at my facility. Company Description & Member BioCompany DescriptionPlease provide one paragraph – 150 words or lessMember BioPlease provide one paragraph – 150 words or less Membership LevelPublic Agencies, Industrial Users and Water Suppliers: 1A - membership includes 1 primary member & 5 additional 1B or 3A affiliate members Manufacturers, Suppliers, Consulting Firms: 2A - membership includes 1 primary member & 3 additional 3B affiliate members 2B - membership includes 1 primary member & 1 additional 3B affiliate member Full-Time Student/Intern 3D - must submit proof along with application Membership Type*1A - Public Agencies, Industrial Users and Water Suppliers, $3001B - Operator Individual Membership, $752A - Manufacturers, Suppliers, Consulting Firms, $4002B - Small Firms - Fewer than 5 employees, $2003A - Affiliate of Divison 1A Member (not an Operator), $753B - Affiliate of Division 2 Member, $1003C - Interested Individuals (not affiliated with any organization), $1253D - Full-Time Student/Intern - 1st Time Member, $03D - Full-Time Student/Intern - Renewing Member, $25Supporting DocumentPlease upload your supporting proof of enrollment document.Affiliate Members Price: $0.00 How many Affiliate Members will you include in this application?Count012345Total $0.00 Affiliate Member 1Salutation - Affiliate 1Mr.Mrs.Ms.Dr.First Name - Affiliate 1Middle Initial - Affiliate 1Last Name - Affiliate 1Job Title - Affiliate 1Email Address - Affiliate 1 Member Bio - Affiliate 1 Affiliate Member 2Salutation - Affiliate 2Mr.Mrs.Ms.Dr.First Name - Affiliate 2Middle Initial - Affiliate 2Last Name - Affiliate 2Job Title - Affiliate 2Email Address - Affiliate 2 Member Bio - Affiliate 2 Affiliate Member 3Salutation - Affiliate 3Mr.Mrs.Ms.Dr.First Name - Affiliate 3Middle Initial - Affiliate 3Last Name - Affiliate 3Job Title - Affiliate 3Email Address - Affiliate 3 Member Bio - Affiliate 3 Affiliate Member 4Salutation - Affiliate 4Mr.Mrs.Ms.Dr.First Name - Affiliate 4Middle Initial - Affiliate 4Last Name - Affiliate 4Job Title - Affiliate 4Email Address - Affiliate 4 Member Bio - Affiliate 4 Affiliate Member 5Salutation - Affiliate 5Mr.Mrs.Ms.Dr.First Name - Affiliate 5Middle Initial - Affiliate 5Last Name - Affiliate 5Job Title - Affiliate 5Email Address - Affiliate 5 Member Bio - Affiliate 5 Payment InformationPayment Method*Credit Card - Online PaymenteCheck (Bank Wire w/o processing fee) - Online PaymentCheckInvoiceIf paying by Check, make payable to Southwest Membrane Operator Association, and mail to 1035 East Vista Way, #103, Vista, CA 92084-4606. Comments & CaptchaIf you would like a copy of the invoice/receipt sent to another*Yes, send copy of invoice/receipt to:No, don't need a copy sentIf yes, you would like a copy of the invoice/receipt sent to another other than the attendee please enter information below.Name* First Last Email Address* Questions/CommentsCaptcha