AWPCA Application

If you prefer to mail in your application you can use the Membership form. If you wish to renew your membership, please login to the website using the link above and return to this page.

Fields in bold are required.

Personal Information First Name: Middle Name: Last Name: Suffix: (PE, PhD, etc)

Business Information Employer: (if applicable) Title: Address: City: State: AA AB AK AL AR AS AZ BC CA CO CT DC DE DF FL FM GA GU HI IA ID IL IN KS KY LA MA MB MD ME MH MI MN MO MP MS MT NB NC ND NE NF NH NJ NL NM NS NT NV NY OH OK ON OR PA PE PQ PR PW RI SC SD SK TN TX UT VA VI VT WA WI WV WY YT Zipcode: Phone:   FAX   Email: Web Site: Sponsor:

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Please help us serve you better by indicating the categories that best describe your business/industry, environmental focus, job title, and field services.

Business Industry: Publically owned municipal or special district, water, wastewater treatment system or plant processing >1mgd or 44L/sec Publically owned municipal or special district, water, wastewater treatment system or plant processing <1mgd or 22L/sec Administration and/or enforcement of government enviromental programs; Administration of public health programs Private or investor owned facility Private industrial systems Consultant Contractor Manufacturer (equipment and representatives) Distributor (equipment and representatives) Educational institutions (all components) Research Laboratory Other

Field Served: Water supply only Wastewater only Both Industries Other Environmental Focus: Wastewater Water Process Water Ground Water Solid Waste Storm Water Pollution Prevention Residual/Biosolids Management Coastal, River, Lake Ecology/Surface Water Toxic and Hazardous Materials Public Education/Information Instrumentation/Automation Controls Other

Job Title: Executive Management Engineering/Non Managerial Scientific/Non Managerial Purchasing Operations Marketing and Sales / Non Managerial Student Retired Industry Representative Other

AWPCA Annual Dues: 
Individual: $40
Student: $15

Pressing the Register button will direct you to a secure site to complete the credit card transaction