CTWEA Registration Form "*" indicates required fields Step 1 of 2 50% Choose an event*Select eventCTWEA Spring Wastewater Forum & Expo Continental breakfast, all breaks and lunch are included. View Agenda >> To purchase an exhibit booth for this show, please Sign Up Here >> Deadline to sponsor/exhibit is May 1st Please completeOrganization/Company/Town/WPCA*Billing Contact Name* First Last Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Billing Contact Phone*Billing Contact Email* Attendee Information Please provide names and email addresses for each attendee. Each person will need to register separately especially to receive credit for TCHs.CTWEA Membership will be verified. Any registrants that signs up as a member but does not have a current membership, will be charged the non-member rate. Please contact info.ctwea@gmail.com with any questions. Attendee Name #1* First Last Email Select a registration option* CTWEA Member - $90 Non Member - $100 Speaker - complimentary Exhibit pass (additional) - $90 Any Dietary Needs?Would you like to register a second attendee?* Yes No Attendee Name #2* First Last Email Select a registration option* CTWEA Member - $90 Non Member - $100 Speaker - Complimentary Exhibit pass (additional) - $90 Any Dietary Needs?Would you like to register a third attendee?* Yes No Attendee Name #3* First Last Email This field is hidden when viewing the formIs Attendee #3 a member?*please selectYesNoSelect a registration option* CTWEA Member - $90 Non Member - $100 Speaker - Complimentary Exhibit pass (additional) - $90 Any Dietary Needs?Would you like to register a fourth attendee?* Yes No Attendee Name 4* First Last Email This field is hidden when viewing the formIs Attendee #4 a member?*please selectYesNoSelect a registration option* CTWEA Member - $90 Non Member - $100 Speaker - Complimentary Exhibit pass (additional) - $90 Any Dietary Needs?Would you like to register a fifth attendee?* Yes No Attendee Name 5* First Last Email This field is hidden when viewing the formIs Attendee #5 a member?*please selectYesNoSelect a registration option* CTWEA Member - $90 Non Member - $100 Speaker - Complimentary Exhibit pass (additional) - $90 Any Dietary Needs?Would you like to register a sixth attendee?* Yes No Attendee Name 6* First Last Email This field is hidden when viewing the formIs Attendee #6 a member?*please selectYesNoSelect a registration option* CTWEA Member - $90 Non Member - $100 Speaker - Complimentary Exhibit pass (additional) - $90 Any Dietary Needs?Would you like to register a seventh attendee?* Yes No Attendee Name 7* First Last Email This field is hidden when viewing the formIs Attendee #7 a member?*please selectYesNoSelect a registration option* CTWEA Member - $90 Non Member - $100 Speaker - Complimentary Exhibit pass (additional) - $90 Any Dietary Needs?Would you like to register a eighth attendee?* Yes No Attendee Name 8* First Last Email This field is hidden when viewing the formIs Attendee #8 a member?*please selectYesNoSelect a registration option* CTWEA Member - $90 Non Member - $100 Speaker - Complimentary Exhibit pass (additional) - $90 Any Dietary Needs?Would you like to register a ninth attendee?* Yes No Attendee Name 9* First Last Email This field is hidden when viewing the formIs Attendee #9 a member?*please selectYesNoSelect a registration option* CTWEA Member - $90 Non Member - $100 Speaker - Complimentary Exhibit pass (additional) - $90 Any Dietary Needs?Would you like to register a tenth attendee?* Yes No Attendee Name 10* First Last Email This field is hidden when viewing the formIs Attendee #10 a member?*please selectYesNoSelect a registration option* CTWEA Member - $90 Non Member - $100 Speaker - Complimentary Exhibit pass (additional) - $90 Any Dietary Needs? Payment InformationThe Spring Wastewater Forum & Expo will be held in-person from 8:00AM-3:30PM at the Aqua Turf in Plantsville, CT. Each person must register separately. Total Amount Due You will receive an email confirmation shortly regarding your registration. If you do not receive an email, please contact info.ctwea@gmail.comPayment Methodselect payment methodPay by Credit CardCheck (made payable to CTWEA)Purchase Order #Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name Checks must be made out to CTWEA for the time being. Please send to: CTWEA 10 Tower Office Park, Suite 601 Woburn, MA 01801 Questions please email info.ctwea@gmail.comPurchase Order #please enter a purchase order #
