CTWEA Registration CTWEA Fall Workshop Registration Form Register to attend or exhibit using this online form for the upcoming CTWEA Fall Workshop, October 2, 2024, Aqua Turf, Plantsville, CT. The workshop will be held from 8:00AM-12:15PM and will include breakfast buffet and mid-morning break. Water treatment plant operators, consulting engineers, public works officials and regulators are expected to be in attendance. 2.75 Training Contact Hours (TCHs) will be awarded for CT operators. View the Program Flyer HereOrganization/Company/Town/WPCA(Required) Billing Contact Name(Required) First Last Billing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Billing Contact Phone(Required)Billing Contact Email(Required) REGISTRATIONRegistration Type(Required)Select Registration TypeAttendeeWorkshop Sponsor Only - $525Exhibit Tabletop - $350 (incl. one registration)Break Sponsor Only - $200Door Prize Sponsor OnlyExhibitor Name #1(Required) First Last Exhibitor Email #1(Required) Would you like to register a second exhibitor?(Required) Yes No Exhibitor Name #2(Required) First Last Exhibitor Email #2(Required) Exhibit Registration Fees(Required) Registration & Associate Membership - $160 Non Member Registration - $90 Associates Membership is for consulting engineers, vendors and other supporting professionals. Attendee Information Please provide names and email addresses for each attendee. Each person will need to register separately especially to receive credit for TCHs. Attendee Name #1(Required) First Last Attendee Email #1(Required) Select a registration option(Required) Registration & Municipal Membership - $80 Registration & Associate Membership - $160 Non Member Registration - $90 Speaker - complimentary Current Member - $60 (must have current membership) RENEW YOUR MEMBERSHIP! Municipal Memberships are reserved for a municipality, WPCA board of directors, city/town or regulators within the State of CT. Associates Membership is for Consulting engineers, vendors and other supporting professionals. If you have a current 2023-2024 membership, your membership will be automatically extended.Would you like to register a second attendee?(Required) Yes No Attendee Name #2(Required) First Last Email(Required) Select an option(Required) Registration & Municipal Membership - $80 Registration & Associate Membership - $160 Non Member Registration - $90 Speaker - complimentary Current Member - $60 (must have current membership) Register for the workshop and renew your membership. Municipal Memberships are reserved for a municipality, WPCA board of directors, city/town or regulators within the State of CT. Associates Membership is for Consulting engineers, vendors and other supporting professionals. If you have a current 2022-2023 membership, your membership will be automatically extended.Would you like to register a third attendee?(Required) Yes No Attendee Name #3(Required) First Last Email(Required) Select an option(Required) Registration & Municipal Membership - $80 Registration & Associate Membership - $160 Non Member Registration - $90 Speaker - complimentary Current Member - $60 (must have current membership) Register for the workshop and renew your membership. Municipal Memberships are reserved for a municipality, WPCA board of directors, city/town or regulators within the State of CT. Associates Membership is for Consulting engineers, vendors and other supporting professionals. If you have a current 2022-2023 membership, your membership will be automatically extended.Would you like to register a fourth attendee?(Required) Yes No Attendee Name 4(Required) First Last Email(Required) Select an option(Required) Registration & Municipal Membership - $80 Registration & Associate Membership - $160 Non Member Registration - $90 Speaker - complimentary Current Member - $60 (must have current membership) Register for the workshop and renew your membership. Municipal Memberships are reserved for a municipality, WPCA board of directors, city/town or regulators within the State of CT. Associates Membership is for Consulting engineers, vendors and other supporting professionals. If you have a current 2022-2023 membership, your membership will be automatically extended.Would you like to register a fifth attendee?(Required) Yes No Attendee Name 5(Required) First Last Email(Required) Select an option(Required) Registration & Municipal Membership - $80 Registration & Associate Membership - $160 Non Member Registration - $90 Speaker - complimentary Current Member - $60 (must have current membership) Register for the workshop and renew your membership. Municipal Memberships are reserved for a municipality, WPCA board of directors, city/town or regulators within the State of CT. Associates Membership is for Consulting engineers, vendors and other supporting professionals. If you have a current 2022-2023 membership, your membership will be automatically extended.Would you like to register a sixth attendee?(Required) Yes No Attendee Name 6(Required) First Last Email(Required) Select an option(Required) Registration & Municipal Membership - $80 Registration & Associate Membership - $160 Non Member Registration - $90 Speaker - complimentary Current Member - $60 (must have current membership) Register for the workshop and renew your membership. Municipal Memberships are reserved for a municipality, WPCA board of directors, city/town or regulators within the State of CT. Associates Membership is for Consulting engineers, vendors and other supporting professionals. If you have a current 2022-2023 membership, your membership will be automatically extended.Would you like to register a seventh attendee?(Required) Yes No Attendee Name 7(Required) First Last Email(Required) Select an option(Required) Registration & Municipal Membership - $80 Registration & Associate Membership - $160 Non Member Registration - $90 Speaker - complimentary Current Member - $60 (must have current membership) Register for the workshop and renew your membership. Municipal Memberships are reserved for a municipality, WPCA board of directors, city/town or regulators within the State of CT. Associates Membership is for Consulting engineers, vendors and other supporting professionals. If you have a current 2022-2023 membership, your membership will be automatically extended.Would you like to register a eighth attendee?(Required) Yes No Attendee Name 8(Required) First Last Email(Required) HiddenIs Attendee #8 a member?(Required)please selectYesNoSelect an option(Required) Registration & Municipal Membership - $80 Registration & Associate Membership - $160 Non Member Registration - $90 Speaker - complimentary Current Member - $60 (must have current membership) Register for the workshop and renew your membership. Municipal Memberships are reserved for a municipality, WPCA board of directors, city/town or regulators within the State of CT. Associates Membership is for Consulting engineers, vendors and other supporting professionals. If you have a current 2022-2023 membership, your membership will be automatically extended.Would you like to register a ninth attendee?(Required) Yes No Attendee Name 9(Required) First Last Email(Required) HiddenIs Attendee #9 a member?(Required)please selectYesNoSelect an option(Required) Registration & Municipal Membership - $80 Registration & Associate Membership - $160 Non Member Registration - $90 Speaker - complimentary Current Member - $60 (must have current membership) Register for the workshop and renew your membership. Municipal Memberships are reserved for a municipality, WPCA board of directors, city/town or regulators within the State of CT. Associates Membership is for Consulting engineers, vendors and other supporting professionals. If you have a current 2022-2023 membership, your membership will be automatically extended.Would you like to register a tenth attendee?(Required) Yes No Attendee Name 10(Required) First Last Email(Required) HiddenIs Attendee #10 a member?(Required)please selectYesNoSelect an option(Required) Registration & Municipal Membership - $80 Registration & Associate Membership - $160 Non Member Registration - $90 Speaker - complimentary Current Member - $60 (must have current membership) Register for the workshop and renew your membership. Municipal Memberships are reserved for a municipality, WPCA board of directors, city/town or regulators within the State of CT. Associates Membership is for Consulting engineers, vendors and other supporting professionals. If you have a current 2022-2023 membership, your membership will be automatically extended.Sponsor Opportunities Workshop Sponsor - $525 Break Sponsor - $250 Door Prize Sponsor - $25 each Sponsors will receive recognition on the program, email blasts, website and during the event. Must be received by 9/20/24 to be printed on the sign board.Gift Card Quantity(Required) Price: $25.00 Quantity Enter how many gift cards you would like. CTWEA will purchase gift cards on your behalf and they will be raffled off at the end of the event.Payment InformationTotal Amount Due Payment Method(Required)Select optionPay by Credit CardCheck/Purchase OrderCredit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name Make checks payable to CTWEA and mail to: CTWEA 10 Tower Office Park, Suite 601 Woburn, MA 01801 Contact: info.ctwea@gmail.com if you need a W-9Purchase Order # please enter a purchase order #CAPTCHA Δ