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2012 Technical Conference Registration

TO REGISTER: Online registration is open TODAY - register online below. Contact Tia Jeter (tjeter@aquaterra-env.com or 913-681-0030) or Steve Fishman (Fishman.Steve@epamail.epa.gov or 913-551-7158) for questions. CONFERENCE COST: NOTE: Pre-registration at the reduced rate ends on January 11th but you may continue to register and pay online up until the day of the conference. Attendees who have not pre-registered online and register on the day of the conference will be billed at the higher rate. 1) AWMA OR CHMM Member: $60 (PRE-REGISTERED)/$70 (after Jan. 11 or AT DOOR) 2) Guest: $85 / $60 if registering four or more individuals /$95 (after Jan. 11 or AT DOOR) 3) Students*: $20 for the first 30 students, $60 after that (*students may attend the last session of the day/social for free) 4) New member with annual National AWMA membership (or lapsed member of more than 12 months) & conference registration: $190 5) Sponsorship: $350 (plus $60 for attendees from sponsoring company) 6) Speakers: please fill out the sections below to indicate your attendance as our guest **We would prefer that you pay online, however if you wish to send a check for payment please make the check payable to AWMA Midwest Section and mail to Tia Jeter at the following address: Aquaterra ATTN: Tia Jeter, AWMA Treasurer 7311 W. 130th street, suite 100 Overland Park, KS 66213

RSVP to 2012 Technical Conference

If you are not currently a member of AWMA or you are a member who has let their membership lapse for more than one year, would you like to join/renew at special rate of $190 for both a new/renewed membership plus your conference registration (save $85 by opting for this reduced membership rate plus attending at the "members rate")? *Note: if you are choosing this option, please fill out a separate registration form for each person registering for the conference and renewing their annual membership. No Yes (if yes, specify "yes" to "AWMA Member?" below)

If yes, please download membership application and mail to Tia Jeter or turn in when you check in at the technical conference. You may pay for your membership via credit card online when you pay for your conference registration or you may bring a check to the conference along with your membership application. *NOTE - this option is only available to non-members or members whose membership has lapsed for more than one year. Other members wishing to renew will need to do so directly with A&WMA headquarters.

Will Attend?	Speaker?	Assoc. Member?	Student?	Info
1	Yes No	Yes No	Yes - attending all day Yes - attending only last session for free I am not a student	Name:  Company:  Email:  Phone:
1	Yes No	Yes No	Yes - attending all day Yes - attending only last session for free I am not a student	Name:  Company:  Email:  Phone:
1	Yes No	Yes No	Yes - attending all day Yes - attending only last session for free I am not a student	Name:  Company:  Email:  Phone:
1	Yes No	Yes No	Yes - attending all day Yes - attending only last session for free I am not a student	Name:  Company:  Email:  Phone:
1	Yes No	Yes No	Yes - attending all day Yes - attending only last session for free I am not a student	Name:  Company:  Email:  Phone:
If you are sponsoring this year's technical conference please fill in this section. I am providing sponsorship in the amount of: $ (sponsorship amount is $350 and does not include conference registration fee)
If you are a conference speaker please let us know which sessions to plan to attend. I will attend: Morning sessions: Yes No Afternoon sessions: Yes No Lunch session: Yes No Closing session: Yes No
Comments:
Please specify any dietary requests, if applicable.
I will:
pay now by credit card   send a check or bring a check to registration
Enter Code In Image Below:

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