Membership in NACWA

Public Agency Membership Application


We (agency name) , with a service population of , request membership in NACWA.

This application certifies that we are a metropolitan, county, or city public agency that treats wastewater, conveys wastewater, and/or manages stormwater. We will subscribe to the mission of the Association and agree to pay the annual membership dues as detailed in the dues statement. (Dues invoices are mailed in September, payable by December 1st. Dues are prorated quarterly for new members. Contact the National Office at 202.833.2672 after January 1 for your adjusted membership fee.)

 

My Agency provides the following services (check all that are appropriate):

Collection System (incl. Pump Stations)
  Interceptor (incl. Pump Stations)
Treatment (incl. Biosolids Management)
Reclaimed Wastewater/Reuse
Municipal Stormwater
Wholesale Drinking Water
  Drinking Water Distribution
Other Services:
 

My Agency type is (select one):

City Government Department
City Authority
County Department
County Authority
Special District
Regional Authority
Other:
 

 

Name of Agency:
Name of Agency Representative to NACWA:
Nickname:
Title:
Address:
City:
State:
Zip:
Phone:
Fax:
Email Address:

 

I would like to add the following members of my staff to receive NACWA e-Alert notifications:

Name Title E-mail
 

Did an individual at a current NACWA member agency refer you to the Association?  Yes  No
 
If yes who?

Name:
Title:
Firm/Organization:
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