SWMOA Online Training Sponsorship RegistrantPlease refrain from using all caps/uppercase letters, please use sentence structure letter case.Salutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast Name*Job Title*Company*Address*City*State*Not Applicable, InternationalALAKAZARCACOCTDCDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYZip/Postal Code*Country*USAAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweEmail*Enter registered attendee's email address Phone*Cell PhoneWebsite Member (check all that apply) SWMOA AMTA Billing Contact InformationEnter billing contact information, if applicableBe advised, SWMOA’s mailing address has changed: 2409 SE Dixie Hwy., Stuart, FL 34996Billing Contact NameBilling Contact EmailEnter billing contact's email address, if applicable Billing Contact Phone Please send copy of the invoice/receipt to Billing Contact Please send copy of the invoice/receipt to Billing Contact Sponsor Opportunities Online Training Sponsor List of Participants Logo Recognition throughout the Webinar Company Branding on Event Materials, Website and Online Training Platform Sponsor Recognition in Newsletter/Event Section Sponsor Recognition via Social Media Event Promotions (1) Complimentary Registration to attend Webinar Series SWMOA Online Training: Introduction to Membranes - 3 Part Series $450 Part 1: Tuesday, Mar. 16th Part 2: Tuesday, Mar. 23rd Part 3: Tuesday, Mar. 30th RO Membrane Challenges and Solutions - 3 Part Series $450 Part 1: Tuesday, Apr. 6th Part 2: Tuesday, Apr. 13th Part 3: Tuesday, Apr. 27th Membrane Maintenance: Pumps, Instrumentation Controls, Valves - 3 Part Series $450 Part 1: Tuesday, May 4th Part 2: Tuesday, May 11th Part 3: Tuesday, May 18th SWMOA Presents: Tracy’s Technical Tips & Ops Chats - 4 Part Series $500 Dates will be announced soon Event SponsorOnline Training4-Part3-Part2-PartIndividual A discounted rate will apply when Sponsoring all 3 3-Part Series Events for 2021. An additional discounted rate will apply when Sponsoring all 3 3-Part Series Events plus Tracy's Tech Tips 4-Part Series for 2021.Sponsor Event Introduction to Membranes 3-Part Series, $450 RO Membrane Challenges and Solutions 3-Part Series, $450 Membrane Maintenance 3-Part Series, $450 SWMOA Presents: Tracy’s Technical Tips & Ops Chats 4-Part Series, $500 Event Sponsor: 4-Part Series SWMOA Presents: Tracy’s Technical Tips & Ops Chats 4-Part Series, $500 Select option(s) below to sponsor all 3 3-Part Series Events or all 3 3-Part Series Events plus Tracy's Tech Tips 4-Part Series to receive the discount noted above.Event Sponsor: All 3 3-Part Series Events discountSelect option(s) below to sponsor all 3 3-Part Series Events or all 3 3-Part Series Events plus Tracy's Tech Tips 4-Part Series to receive the discount noted above. All 3 3-Part Series Events, $1,224 Event Sponsor: 4-Part Series Discount SWMOA Presents: Tracy’s Technical Tips & Ops Chats 4-Part Series, $480 Will you be the Comp. Attendee?*(1) Complimentary Registration to attend Series is included with the Sponsorship.I will be the Comp. Attendee to SeriesAnother will be the Comp. Attendee to Series; send Comp. Registration link Company Logo and DescriptionCheck box(s) to upload/update logo or description Company Logo Company Description Upload Company Logo*please provide a High Resolution, 300 DPI or greater Drop files here or Company Description*please provide one paragraph – 150 words or less Attendee RegistrationAttendee Registration*Comp. Full Series Online Training, $0 Online Training Policy* Online Training Technical Requirements SWMOA provides each attendee with the link to access the online training along with instructions. Participants are responsible for ensuring that: they have the needed equipment; it is functioning; it is compatible with the online training system; and they know how to use it. SWMOA is not responsible for technical support before, during or after the online training. For technical support, please visit https://support.goto.com/webinar. SWMOA’s refund policy excludes attendees experiencing technical difficulties or equipment failures. SWMOA online trainings are conducted using GoToWebinar. It is highly recommended that you use the link provided to the GoToWebinar website to view compatibility requirements prior to the scheduled training. You must have access to a computer with an internet connection and an audio connection (phone line or computer mic and speaker). It is recommended that you participate from a quiet location where there will be few distractions. Online Training Continuing Education Units Requirements Inability to complete CEU requirements will result in no CEU’s being issued, regardless of the reason. • Attendees must pre‐register and provide a valid certification number. • Each attendee must be logged into a separate computer so that their participation may be accurately tracked. • Attendees must be logged in at the beginning and must remain logged in through the end of the session. • Attendees must promptly respond to brief quizzes or polling questions that appear randomly throughout the online training. • No partial credit will be given. • After the online training, SWMOA staff will email CEU documentation to attendees meeting the CEU requirements. Reports will also be sent to the appropriate certification agencies. Online Training Recordings Online training participants should be aware that the online training they attend will be recorded. SWMOA holds a perpetual license to copy, distribute, make videos, DVDs, CDs, publish, reproduce the recording, to post the recording on its website, to sell the recording or any copy or derivative thereof, to market and publicize the recording, all without any fee or compensation paid or to be paid to participants by SWMOA. Prohibition of Recording: Recording of any sounds or visual images and use of any recording device now known, or later developed, is prohibited unless prior written permission has been expressly granted by SWMOA. I agree to the Online Training Policy Personal / Preferred Email Address to send Virtual Access LinkIf providing an alternate email other than listed above for receiving virtual access, provide the email address here. Contact Hours/CEUs AvailableNeed Contact Hours/CEUs?*Included in registration fee.Yes, Contact Hours/CEUs RequiredNo, Contact Hours/CEUs RequiredI acknowledge that to receive CEU credit, I must:* I acknowledge that to receive CEU credit, I must: ✱ Be in attendance/logged in and actively engaged during the Online Training (watching the recorded video of the event is not applicable) Provide valid license information Receive CEU credit only for actual time attended License State*License TypeLicense GradeLicense #* Total $0.00 Payment InformationPayment Method*Credit Card - Online PaymenteCheck (Bank Wire w/o processing fee) - Online PaymentCheckInvoiceMake payable to: Southwest Membrane Operator Association2409 SE Dixie Hwy., Stuart, FL, 34996. Written cancellation requests received by SWMOA on or before Apr. 5, 2013 will receive a refund, less a $50 processing fee. Full payment is required if cancellation is received on or after Apr. 6, 2013 - no refunds and no credits for future events will be granted. However, substitutions may be made at any time. SWMOA reserves the right to make changes in programs and speakers, or to cancel programs when conditions beyond its control prevail. Every effort will be made to contact each enrollee if a program is cancelled. If a program is not held, SWMOA’s liability is limited to the refund of the program fee only. Comments & CaptchaComments Please refer to SWMOA’s Privacy Policy if you have any questions regarding your preferences.CAPTCHA