Fall Training - Exhibitor Registration

Members: Please be sure that your Membership Dues are paid for this year, or pay the Non-Member rate.

• Company Name for Booth Sign*
• Contact Person*
  First Last
• Address*
  Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code
• Phone*
• Email*
• Fax
• Company products/services
• BOOTH REGISTRATION*
  Select your membership type to see options Exhibit Area comes with 1 table & 2 Chairs
  • Diamond/Platinum Member
  • Gold Associate Member
  • Basic/Silver Associate Member
  • Non-Member
• {https://msrwa.org/membership/associate-application/}
• I would like to Exhibit at the Fall Training*
  • Yes
  • No, I would like a One Day Exhibit Hall Pass
• I would like to participate as an Exhibit Hall Instructor.*
  (In your Booth Training)
  • Yes
  • No
• Time Slots-Available to participate in on October 15, 2023*
  (Choose one or all - If your product is a water & Wastewater product you will want to do a water & wastewater time slots or all time slots)
  • Select All
  • 9:00 AM - Water Attendees
  • 10:00 AM - Wastewater Attendees
  • 1:00 PM - Water Attendees
  • 2:00 PM - Wastewater Attendees
• Company Name*
• Instructor Name(s)*
• Topic of Discussion*
• Phone #:*
• Email for Instructor:*
• Fax #:*
• Diamond/Platinum Exhibitor Member Price
  With Three Booth Attendees
  Price:
• Gold Exhibitor Member Price
  With Three Booth Attendees
  • Yes, We used our VIP Free Booth at the Operator Expo - $400.00
  • No, We did not exhibit at the Operator Expo & We choose to use our VIP Benefit for Fall Training - $0.00
• Silver/Basic Exhibitor Member Price Quantity
  With Three Booth Attendees
  Price: $400.00 Quantity
• Non Member Exhibitor Price Quantity
  With Three Booth Attendees
  Price: $800.00 Quantity
• I need Electricity at Booth Quantity
  Price: $50.00 Quantity
• Extra Tables Quantity*
  Enter quantity
  Price: $10.00 Quantity
• Name for Badge 1
  First Last
• Name for Badge 2
  First Last
• Name for Badge 3
  First Last
• Name of Company/Manufacturer that you would prefer not to exhibit next to
• One-Day Exhibit Hall Pass - Members Quantity*
  (includes Lunch for the day)
  Price: $125.00 Quantity
• One-Day Exhibit Hall Pass - Non-Members Quantity
  (includes Lunch for the day)
  Price: $250.00 Quantity
• Need Additional Booth Attendees?*
  (Over the 3 Above)
  • Yes
  • No
• EXTRA Booth Attendee(s) - Member*
  (Lunch is included)
  • None
  • 1 Attendee - $50
  • 2 Attendee - $100
  • 3 Attendee - $150
  • 4 Attendee - $200
• EXTRA Booth Attendee(s) - Non-Member Price*
  (Lunch is included)
  • None
  • 1 Attendee - $100
  • 2 Attendee - $200
  • 3 Attendee - $300
  • 4 Attendee - $400
• Additional Name Badge 1
  First Last
• Additional Name Badge 2*
  First Last
• Additional Name Badge 3*
  First Last
• Additional Name Badge 4*
  First Last
• Sponsorship for Breakfast
  Enter amount (optional)
• Sponsorship for Breaks
  Enter amount (optional)
• Sponsorship for Lunch
  Enter amount (optional)
• Donation to MsRWA Scholarship Fund
  Enter donation amount (optional)
• Preferred payment method*
  • Pay online with credit card
  • Mailing a check
  • Paying On-Site
• Total
  $0.00
• Phone
  This field is for validation purposes and should be left unchanged.

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