Join SWMOA – 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. MemberPlease refrain from using all caps/uppercase letters, please use sentence structure letter case.Salutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast Name*SuffixJob Title* Organization & AddressOrganization*Mailing Address*City*State/ProvinceZIP/Postal CodeCountry* Contact InformationTelephone*Cell PhoneEmail Address*Enter applicant's email address Website Billing Contact InformationEnter billing contact information, if applicableBilling Contact Name First Last Billing Contact Email AddressEnter billing contact's email address, if applicable Billing Contact Telephone Please send copy of the invoice/receipt to Billing Contact Volunteer OpportunitiesCommittee Preferences Awards Legislative / Regulatory Membership Operator Certification Program / Technology Transfer Publications / Newsletter Public Relations / Social Media 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, $3601B - Operator Individual Membership, $752A - Manufacturers, Suppliers, Consulting Firms, $4802B - Small Firms - Fewer than 5 employees, $2403A - Affiliate of Divison 1A Member (not an Operator), $753B - Affiliate of Division 2 Member, $1203C - Interested Individuals (not affiliated with any organization), $1503D - Full-Time Student/Intern - 1st Time Member, $03D - Full-Time Student/Intern - Renewing Member, $25Supporting DocumentPlease upload your supporting proof of enrollment document.Included Members Price: $0.00 How many Included Members will you include in this application?Count - Included Members (Div. 1)012345Count - Included Members (Div. 2A)0123Count - Included Members (Div. 2B)01Division 1B - Additional Members Price: $75.00 How many Additional Members will you include in this application?Count - Additional 1B Members012345Division 3B - Additional Members Price: $120.00 How many Additional Members will you include in this application?Count - Additional 3B Members012345Total $0.00 Included Member 1Salutation - Included Member 1Mr.Mrs.Ms.Dr.First Name - Included Member 1Middle Initial - Included Member 1Last Name - Included Member 1Job Title - Included Member 1Email Address - Included Member 1 Member Bio - Included Member 1 Included Member 2Salutation - Included Member 2Mr.Mrs.Ms.Dr.First Name - Included Member 2Middle Initial - Included Member 2Last Name - Included Member 2Job Title - Included Member 2Email Address - Included Member 2 Member Bio - Included Member 2 Included Member 3Salutation - Included Member 3Mr.Mrs.Ms.Dr.First Name - Included Member 3Middle Initial - Included Member 3Last Name - Included Member 3Job Title - Included Member 3Email Address - Included Member 3 Member Bio - Included Member 3 Included Member 4Salutation - Included Member 4Mr.Mrs.Ms.Dr.First Name - Included Member 4Middle Initial - Included Member 4Last Name - Included Member 4Job Title - Included Member 4Email Address - Included Member 4 Member Bio - Included Member 4 Included Member 5Salutation - Included Member 5Mr.Mrs.Ms.Dr.First Name - Included Member 5Middle Initial - Included Member 5Last Name - Included Member 5Job Title - Included Member 5Email Address - Included Member 5 Member Bio - Included Member 5 Additional Member 1Salutation - Additional Member 1Mr.Mrs.Ms.Dr.First Name - Additional Member 1Middle Initial - Additional Member 1Last Name - Additional Member 1Job Title - Additional Member 1Email Address - Additional Member 1 Member Bio - Additional Member 1 Additional Member 2Salutation - Additional Member 2Mr.Mrs.Ms.Dr.First Name - Additional Member 2Middle Initial - Additional Member 2Last Name - Additional Member 2Job Title - Additional Member 2Email Address - Additional Member 2 Member Bio - Additional Member 2 Additional Member 3Salutation - Additional Member 3Mr.Mrs.Ms.Dr.First Name - Additional Member 3Middle Initial - Additional Member 3Last Name - Additional Member 3Job Title - Additional Member 3Email Address - Additional Member 3 Member Bio - Additional Member 3 Additional Member 4Salutation - Additional Member 4Mr.Mrs.Ms.Dr.First Name - Additional Member 4Middle Initial - Additional Member 4Last Name - Additional Member 4Job Title - Additional Member 4Email Address - Additional Member 4 Member Bio - Additional Member 4 Additional Member 5Salutation - Additional Member 5Mr.Mrs.Ms.Dr.First Name - Additional Member 5Middle Initial - Additional Member 5Last Name - Additional Member 5Job Title - Additional Member 5Email Address - Additional Member 5 Member Bio - Additional Member 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. 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