NWMOA Membership Renewal Membership LevelPublic Agencies, Industrial Users and Water Suppliers: 1A - membership includes 1 primary member & 5 additional 1B or 3A affiliate members Manufacturers, Suppliers, Consulting Firms: 2A - membership includes 1 primary member & 3 additional 3B affiliate members 2B - membership includes 1 primary member & 1 additional 3B affiliate memberMembership Type*1A - Public Agencies, Industrial Users and Water Suppliers, $3601B - Operator Individual Membership, $602A - Manufacturers, Suppliers, Consulting Firms, $4802B - Small Firms - Fewer than 5 employees, $2403A - Individual employed by a Public Agency who is not an Operator, $603B - Individuals affiliated with a paid Division 2 Member, $1203C - Other Interested Individuals (not affiliated with any organization, $1503D - Full-Time Student/Intern (must submit proof along with application), $25Submit proof of student full time status*Please upload your supporting proof of enrollment document. MemberPlease refrain from using all caps/uppercase letters, please use sentence structure letter case.Salutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast Name*SuffixJob Title* Organization & AddressOrganization*Mailing Address*City*State*Not Applicable, InternationalALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYZIP/Postal Code*Country*USAAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican 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 RicoQatarRomaniaRussiaRwandaRéunionSaint 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 IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Contact InformationTelephone*Cell PhoneEmail Address*Enter member's email address WebsiteBilling Contact InformationEnter billing contact information, if applicableBilling Contact NameBilling Contact EmailEmail address sent to billing contact, if applicable Billing Contact Phone Please send copy of the invoice/receipt to Billing Contact Volunteer OpportunitiesCommittee Preferences Bylaws/Policies Legislative Operator Certification Membership Public Relations Newsletter Program/Technology Transfer Audit/Finance Awards/Scholarships Election Other Interests I am interested in running for a position on the NWMOA Board of Directors. I am interested in presenting at a Symposium, Workshop, or hosting an event at my facility. Company Description & Member BioCompany DescriptionMember Bio Included MembersHow many Included Members will you include in this application?Included Members Price: $0.00 Count - Included Members (Div. 1A)012345Count - Included Members (Div. 2A)0123Count - Included Members (Div. 2B)01 Included Member 11*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee1r*Replace individual with this employeeDo not renew, do not replacePlease replace the current individual's information with the new person's information Salutation - Included Member 1*Mr.Mrs.Ms.Dr.First Name - Included Member 1*Middle Initial - Included Member 1Last Name - Included Member 1*Job Title - Included Member 1*Email Address - Included Member 1* Member Bio - Included Member 1 Included Member 22*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee2r*Replace individual with this employeeDo not renew, do not replacePlease replace the current individual's information with the new person's information Salutation- Included Member 2*Mr.Mrs.Ms.Dr.First Name - Included Member 2*Middle Initial - Included Member 2Last Name - Included Member 2*Job Title - Included Member 2*Email Address - Included Member 2* Member Bio - Included Member 2 Included Member 33*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee3r*Replace individual with this employeeDo not renew, do not replacePlease replace the current individual's information with the new person's information Salutation - Included Member 3*Mr.Mrs.Ms.Dr.First Name - Included Member 3*Middle Initial - Included Member 3Last Name - Included Member 3*Job Title - Included Member 3*Email Address - Included Member 3* Member Bio - Included Member 3 Included Member 44*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee4r*Replace individual with this employeeDo not renew, do not replacePlease replace the current individual's information with the new person's information Salutation - Included Member 4*Mr.Mrs.Ms.Dr.First Name - Included Member 4*Middle Initial - Included Member 4Last Name - Included Member 4*Job Title - Included Member 4*Email Address - Included Member 4* Member Bio - Included Member 4 Included Member 55*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee5r*Replace individual with this employeeDo not renew, do not replacePlease replace the current individual's information with the new person's information Salutation - Included Member 5*Mr.Mrs.Ms.Dr.First Name - Included Member 5*Middle Initial - Included Member 5Last Name - Included Member 5*Job Title - Included Member 5*Email Address - Included Member 5* Member Bio - Included Member 5 Additional MembersDivision 1B - Additional Members Price: $60.00 How many Additional Members will you include in this application? Count - Additional 1B Members012345Division 3A - Additional Members Price: $60.00 How many Additional Members will you include in this application? Count - Additional 3A Members012345Division 3B - Additional MembersHow many Additional Members will you include in this application? Price: $120.00 Count - Additional 3B Members012345Total $0.00 Additional Member 11a*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee1ar*Replace individual with this employeeDo not renew, do not replace Division 1B - Additional Member 1 - Do Not Renew Price: -$60.00 Division 3B - Additional Member 1 - Do Not Renew Price: -$120.00 Division 3B - Additional Member 1 - Do Not Renew Price: -$120.00 Please replace the current individual's information with the new person's information Salutation - Additional Member 1*Mr.Mrs.Ms.Dr.First Name - Additional Member 1*Middle Initial - Additional Member 1Last Name - Additional Member 1*Job Title - Additional Member 1*Email Address - Additional Member 1* Member Bio - Additional Member 1 Additional Member 22a*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee2ar*Replace individual with this employeeDo not renew, do not replace Division 1B - Additional Member 2 - Do Not Renew Price: -$60.00 Division 3B - Additional Member 2 - Do Not Renew Price: -$120.00 Division 3B - Additional Member 2 - Do Not Renew Price: -$120.00 Please replace the current individual's information with the new person's information Salutation - Additional Member 2Mr.Mrs.Ms.Dr.First Name - Additional Member 2Middle Initial - Additional Member 2Last Name - Additional Member 2Job Title - Additional Member 2Email Address - Additional Member 2 Member Bio - Additional Member 2 Additional Member 33a*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee3ar*Replace individual with this employeeDo not renew, do not replace Division 1B - Additional Member 3 - Do Not Renew Price: -$60.00 Division 3B - Additional Member 3 - Do Not Renew Price: -$120.00 Division 3B - Additional Member 3 - Do Not Renew Price: -$120.00 Please replace the current individual's information with the new person's information Salutation - Additional Member 3Mr.Mrs.Ms.Dr.First Name - Additional Member 3Middle Initial - Additional Member 3Last Name - Additional Member 3Job Title - Additional Member 3Email Address - Additional Member 3 Member Bio - Additional Member 3 Additional Member 44a*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee4ar*Replace individual with this employeeDo not renew, do not replace Division 1B - Additional Member 4 - Do Not Renew Price: -$60.00 Division 3B - Additional Member 4 - Do Not Renew Price: -$120.00 Division 3B - Additional Member 4 - Do Not Renew Price: -$120.00 Please replace the current individual's information with the new person's information Salutation - Additional Member 4Mr.Mrs.Ms.Dr.First Name - Additional Member 4Middle Initial - Additional Member 4Last Name - Additional Member 4Job Title - Additional Member 4Email Address - Additional Member 4 Member Bio - Additional Member 4 Additional Member 55a*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee5ar*Replace individual with this employeeDo not renew, do not replace Division 1B - Additional Member 5 - Do Not Renew Price: -$60.00 Division 3B - Additional Member 5 - Do Not Renew Price: -$120.00 Division 3B - Additional Member 5 - Do Not Renew Price: -$120.00 Please replace the current individual's information with the new person's information Salutation - Additional Member 5Mr.Mrs.Ms.Dr.First Name - Additional Member 5Middle Initial - Additional Member 5Last Name - Additional Member 5Job Title - Additional Member 5Email Address - Additional Member 5 Member Bio - Additional Member 5 Additional 3A Member 11-3a*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee1-3ar*Replace individual with this employeeDo not renew, do not replace Division 3A - Additional Member 1 Price: -$60.00 Please replace the current individual's information with the new person's information Salutation - Additional 3A Member 1*Mr.Mrs.Ms.Dr.First Name - Additional 3A Member 1*Middle Initial - Additional 3A Member 1Last Name - Additional 3A Member 1*Job Title - Additional 3A Member 1*Email Address - Additional 3A Member 1*Member Bio - Additional 3A Member 1 Additional 3A Member 22-3a*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee2-3ar*Replace individual with this employeeDo not renew, do not replace Division 3A - Additional Member 2 Price: -$60.00 Please replace the current individual's information with the new person's information Salutation - Additional 3A Member 2*Mr.Mrs.Ms.Dr.First Name - Additional 3A Member 2*Middle Initial - Additional 3A Member 2Last Name - Additional 3A Member 2*Job Title - Additional 3A Member 2*Email Address - Additional 3A Member 2*Member Bio - Additional 3A Member 2 Additional 3A Member 33-3a*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee3-3ar*Replace individual with this employeeDo not renew, do not replace Division 3A - Additional Member 3 Price: -$60.00 Please replace the current individual's information with the new person's information Salutation - Additional 3A Member 3*Mr.Mrs.Ms.Dr.First Name - Additional 3A Member 3*Middle Initial - Additional 3A Member 3Last Name - Additional 3A Member 3*Job Title - Additional 3A Member 3*Email Address - Additional 3A Member 3*Member Bio - Additional 3A Member 3 Additional IIIA Member 44-3a*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee4-3ar*Replace individual with this employeeDo not renew, do not replace Division 3A - Additional Member 4 Price: -$60.00 Please replace the current individual's information with the new person's information Salutation - Additional 3A Member 4*Mr.Mrs.Ms.Dr.First Name - Additional 3A Member 4*Middle Initial - Additional 3A Member 4Last Name - Additional 3A Member 4*Job Title - Additional 3A Member 4*Email Address - Additional 3A Member 4*Member Bio - Additional 3A Member 4 Additional 3A Member 55-3a*Yes, renew this individual's membershipDo not renew this individual, no longer an employeeDo not renew this individual, still an employee5-3ar*Replace individual with this employeeDo not renew, do not replace Division 3A - Additional Member 5 Price: -$60.00 Please replace the current individual's information with the new person's information Salutation - Additional 3A Member 5*Mr.Mrs.Ms.Dr.First Name - Additional 3A Member 5*Middle Initial - Additional 3A Member 5Last Name - Additional 3A Member 5*Job Title - Additional 3A Member 5*Email Address - Additional 3A Member 5*Member Bio - Additional 3A Member 5 Payment InformationTotal $0.00 Payment Method*Credit Card - Online PaymenteCheck (Bank Wire w/o processing fee) - Online PaymentCheckInvoiceMail checks payable to: Northwest Membrane Operator Association (NWMOA) 2409 SE Dixie Hwy., Stuart, FL 34996 Comments & CaptchaQuestions/CommentsCAPTCHAPlease refer to NWMOA’s Privacy Policy if you have any questions regarding your preferences.