SWMOA 2019 Annual Symposium – Exhibitor/Sponsor Registration – Riverside, CA SWMOA 2019 Annual Symposium"Increasing Membrane Consciousness:How the Southwest Continues to Improve Membrane Treatment"June 24-26, 2019 - Riverside Convention Center, Riverside, CA RegistrantSalutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast Name*Job Title*Company*Address*City*State*Zip/Postal Code*Country*Phone*CellEmail*Enter registered attendee's email address Email for billing contact*Email address sent to billing contact, if applicable Attendee materials delivery email option*Yes, I would like to have the materials sent to another email addressNo, I would like to have the materials sent to the email aboveAttendee materials will be sent approx. 2 weeks after event, provide an email address compatible to receive and/or access Hightail messages.Attendee materials email address* If you prefer to an email other than listed above, provide the email address here.Website Special Needs Food Allergies (describe in comments) Gluten Free Meals Halal Meals Vegan Meals Vegetarian Meals Wheelchair Access Other (describe in Comments) Communication and Data Sharing PreferenceSWMOA has been diligent in Data Security and being compliant with US and other Nations regulations in sharing your contact information as well as receiving email communications from SWMOA on upcoming events and other resources.I would like to receive email messages from SWMOA about Events, Newsletter or Activities*YesNoAuthorization for receiving publication email notification from SWMOA.(applies to all email addresses on this form)I would like to network with SWMOA Members, Operators, Attendees, Speakers, Moderators, Exhibitors, Sponsors or Board, please share my contact information (cell phone # will not be shared)*YesNo Sponsor OpportunitiesAll sponsorship is available on a first-come, first-serve basis and recorded based upon receipt of full payment. Sponsors will receive: Fun Networking Event Sponsor: Includes recognition as the Fun Networking Event Sponsor, and 1 Exhibit package or 2 Full Registrants Bag Sponsor: Includes Logo on bags, recognition on the event as a Bag Sponsor and 2 Full Registrants Platinum Level: Includes 1 Exhibit Space or 2 Full Registrants, and recognition at Welcome Reception and Lunch Events Gold Level: Includes 1 Exhibit Space or 2 Full Registrants, and recognition at Lunch Events Silver Level: Includes recognition at Breakfasts (does not include registrant) Bronze Level: Includes recognition at Breaks (does not include registrant) All sponsors will receive: List of attendees sent via e-mail two weeks prior Acknowledgement in the attendee materials - 100-word company description Sign recognition during the programLogo included in brochure if received prior to printing Event Sponsor*Fun Networking Event Sponsor, $5,000Bag Sponsor, $2,500Platinum Sponsor, $2,000Gold Sponsor, $1,500Silver Sponsor, $800Bronze Sponsor, $500No, SponsorshipFor full details: more informationSponsorship Package: Your Choice*Exhibit Package Includes 1 Full Attendee with Table-Top Exhibit2 Full Attendees Includes 1 Additional Full Attendee RegistrationIncluded in the sponsorship package.Included Attendee*Yes, same as aboveNo, different than aboveIncluded in the sponsorship package.Upload Company LogoAccepted file types: jpg, gif, png, pdf, eps.please provide a High Resolution, 300 DPI or greaterCompany Description*100-word company description Exhibit OpportunitiesAll Exhibitors must have company membership (not individual membership with SWMOA).Exhibitors will receive: One 6’ Table (Chairs are available upon request) One full attendee registration to the Symposium Electricity is available from the Hotel for an additional fee List of attendees sent via e-mail two weeks prior Exhibit Space*Table Top Exhibit, $75010% Deposit: Table Top Exhibit, $75No, ExhibitAllocated on a first come/first serve basis upon receipt of 10% deposit. Deposit fee must be paid by April 19, 2019 and full payment due by May 17, 2019 or deposit and booth space will be forfeited.Included Attendee*Yes, same as aboveNo, different than aboveIncluded in the exhibitor package. Included Attendee 1If different from above.Salutation - Included Attendee 1*Mr.Mrs.Ms.Dr.First Name - Included Attendee 1*Last Name - Included Attendee 1*Job Title - Included Attendee 1*Company - Included Attendee 1*Address - Included Attendee 1*City - Included Attendee 1*State -Included Attendee 1*Zip/Postal Code - Included Attendee 1*Phone - Included Attendee 1*Email - Included Attendee 1* Included Attendee 2Salutation - Included Attendee 2*Mr.Mrs.Ms.Dr.First Name - Included Attendee 2*Last Name - Included Attendee 2*Job Title - Included Attendee 2*Company - Included Attendee 2*Address - Included Attendee 2*City - Included Attendee 2*State - Included Attendee 2*Zip/Postal Code - Included Attendee 2*Phone - Included Attendee 2*Email - Included Attendee 2* Total Registration FeeTotal Registration Fee $0.00 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 E. Vista Way. #103, Vista, CA 92084. CommentsIf 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* Comments or Instructions Written cancellation requests received by SWMOA on or before April 16, 2019 will receive a refund, less a 25% processing fee. Full payment is required if cancellation is received on or after April 17, 2019 - 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. toward the scheduled event. Final Step of Application ProcessCAPTCHAPlease enter the letters displayed above to complete your application and then click Submit.