NWMOA Workshop Registration – Butte, MT – August 27-28, 2019 Membrane Applications & Training: Industrial, Wastewater & Drinking Water Workshop Basin Creek Water Treatment Plant, Butte, MT Tuesday-Wednesday | August 27-28, 2019 RegistrantPlease refrain from using all caps/uppercase letters, please use sentence structure letter case.Salutation*Mr.Mrs.Ms.Dr.First Name*Last Name*Company*Job Title*Address*City*State*Zip/Postal Code*Country*Phone*CellEmail*Enter registered attendee's email address Website Special Needs Food Allergies (describe in comments) Gluten Free Meals Paleo Meals Vegan Meals Vegetarian Meals Wheelchair Access Other (describe in Comments) Member (check all that apply) NWMOA AMTA Billing Contact InformationEnter billing contact information, if applicableBilling Contact Name First Last Billing Contact EmailEmail address of billing contact, if applicable Billing Contact Phone Please send copy of the invoice/receipt to Billing Contact NWMOA - Membrane Operator TrainingEarly rates apply to registration and payment received on or before August 6, 2019.Today - Date Date Format: MM slash DD slash YYYY Early Workshop Registration*Members, $200If you are not a NWMOA Member, please Click Here to join, prior to registering.Workshop Registration*Members, $300For other types of membership - please contact NWMOA for membership application, or click here to apply for membership now. Contact Hours for Water/Wastewater*Contact Hours for Water/WastewaterNo Contact Hours RequiredLicense #*License State*License Type*License Grade* Total Registration Fee $0.00 Payment InformationPayment Method*Credit Card - Online PaymenteCheck (Bank Wire w/o processing fee) - Online PaymentCheckInvoiceIf paying by check: Make checks payable to: Northwest Membrane Operator Association (NWMOA) and mail to: 12592 West Explorer Dr., Ste. 200, Boise, ID 83713. Written cancellation requests received on or before August 6, 2019 will receive a refund, less a $50 processing fee. Full payment is required if cancellation is received on or after August 7, 2019 - no refunds and no credits for future events will be granted. However, substitutions may be made at any time. NWMOA 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, NWMOA’s liability is limited to the refund of the program fee only. Comments and CaptchaQuestions/Comments CAPTCHAPlease refer to NWMOA’s Privacy Policy if you have any questions regarding your preferences.