Non-Voting County Utility Authority Membership Application Non-Voting County Utility Authority Membership: Any County Utility Authority created by the 2006 Senate Bill 2943 may become a MsRWA non-voting county utility authority member. County*PWS ID#*Name of Organization*Mailing Address* Street Address City 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 State ZIP Code Contact Person* First Last PositionPhone*FaxEmail* Website Water Operator First Last Certification #Expiration Date MM slash DD slash YYYY Wastewater Operator First Last Certification #Expiration Date MM slash DD slash YYYY Membership DuesDues are payable at the time application is submitted. Membership dues will be due annually on the first of the month of which you joined.Annual Dues: Price: Total $0.00 Preferred payment method* Pay online w/ credit card Mail a check Other EmailThis field is for validation purposes and should be left unchanged. Δ
