Water Training-2R/4NR – Columbus

When:

October 4, 2023 @ 7:30 am – 3:00 pm

2023-10-04T07:30:00-05:00

2023-10-04T15:00:00-05:00

Where:

East Lowndes Water Association
1325 Ridge Rd Columbus MS 39705

Cost:

Free

Please pre-register as Lunch will be provided.

You can pre-register by Submitting the online form below or faxing in the form.

Please submit a separate form for each attendee.

Training Registration

Please submit a separate form for each attendee.
EVENT INFO
Event Name*
Start Date*
MM slash DD slash YYYY
Total Cost

Total fees due for this attendee
ATTENDEE INFO
Attendee Name*
First Last
Phone*
Email*
Mailing Address*
Street Address City State ZIP Code
Certification #
Expiration Date
MM slash DD slash YYYY
SYSTEM INFO
System/Organization Name*
Mailing Address*
Same as Attendee address

Street Address City State ZIP Code
How would you like to pay?*
- I will pay online
- I will mail a check
- Free Training - No payment required
After submitting the form, you will be redirected to our payment page.
Email
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