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ANNUAL FALL CONFERENCE

OCTOBER 24-27, 2016


SAN DIEGO
TOWN & COUNTRY HOTEL

What's on the Water Horizon?


___I am a speaker at this conference. Date __________________________________ Time _______________________________________

Attendee Name___________________________________________________________________________________________________________________________________

Title ___________________________________________ Company _________________________________________________________________________________________

Address _________________________________________________________________ City _____________________________________ State__________ Zip_____________

Phone _________________________________________ Cell _____________________________________________ Fax ___________________________________________

Attendee Email________________________________________________________________________ AWWA Member #________________________________________

Type of Membership (check one) ___Individual ___Organization ___Operator/Admin. ___Utility ___

Complimentary Spouse/Guest (If attending) *Household members only. Does not include Water Industry Personnel____________________________________________

Early PRE Onsite


Member Registration On or Before On or Before On or Before
8/ 22/ 16 10/ 10/ 16 10/ 11/ 16 Lunches
FULL REGISTRATION: Includes All Technical sessions, Keynote
Lunch & Exhibitor Hosted Lunch & Exhibitor Event
$445 $495 $545 If not included with registration fee

Keynote Lunch $50


Tuesday One-Day : Includes Keynote Lunch
& Exhibitor Event $225 $275 $315 $ ________
Exhibitor Hosted Lunch $50
Wednesday One-Day : Includes Exhibitor Hosted Lunch
& Exhibit Hall Entrance $225 $275 $315 $ ________ Subtotal $___________
EDUCATION PACKAGE Wednesday/Thursday $275 $275 $315 $ ________
Includes Technical Sessions & Exhibit Hall Entrance
NO MEALS NO MEALS NO MEALS
Thursday One-Day Includes Technical Sessions
$149 $149 $149 $ ________
SPECIAL EVENTS

STUDENT - Must be full time Student/AWWA Student Member FREE FREE FREE Tues. Technical Tour $55.00
RETIREE REGISTRATION - Must be: 1) Retired from all gainful employment. 2) A
member of AWWA for at least 15 years. 3) At least 60 years of age.
NO MEALS NO MEALS NO MEALS FREE
$ ________ Wed. Technical Tour $55.00
Water for People Event $40.00
Early PRE Onsite
On or Before On or Before Subtotal $
Non Member Registration 8/ 22 / 16 10/ 10/ 16
On or Before
10/ 11/ 16
Subtotals
FULL REGISTRATION: Includes Keynote Lunch & Exhibitor
Hosted Lunch & Exhibitor Reception
$495 $545 $595 $ ________
CONTACT HOURS
FREE
Tuesday One-Day : Includes Keynote Lunch
& Exhibitor Reception
$275 $325 $375 $ ________ (I am an individual, operator
or administrative
Wednesday One-Day : Includes Exhibitor Hosted Lunch
& Exhibit Hall Entrance
$275 $325 $375 $ ________ AWWA member)

EDUCATION PACKAGE Wednesday/Thursday $325 $350 $375 $ ________ $20.00


Includes Technical Sessions & Exhibit Hall Entrance NO MEALS (My utility/organization is an
NO MEALS NO MEALS
AWWA member or I am not an
Thursday One-Day Includes Technical Sessions $149 $149 $149 $ ________ AWWA member)

PAYMENT METHOD PAYMENT INFORMATION


Registration Total: __________________ Special Events Total: ___________________
Check #______________________________________________________________________________________________
Payable to CA-NV AWWA (U.S. funds)
Contact Hours: ___________________
PO#__________________________________________________________________________________________________ Meal Total: _______________
Must be accompanied by a physical copy of the PO Total Amount Due: ___________________
Credit Card: Visa MC AMEX
Refund requests must be submitted in writing to the Section ofce by
Card No.:_____________________________________________________________________________________________ September 1, 2016. A $50 administrative fee will be deducted from all
refunds. No Refunds Granted after October 1, 2016. By submitting this
Exp. Date:____________________________________________________________________________________________ form, you are consenting to having your photo taken at the event which
may be used for future Section promotions. To opt-out email
Name on Card:_______________________________________________________________________________________ info@ca-nv-awwa.org.

Authorized Signature:________________________________________________________________________________ CA-NV AWWA: 10435 Ashford Street, 2nd Floor


Rancho Cucamonga, CA 91730,
Billing Zip Code:______________________________________________________________________________________ Phone: (909) 481-7200
Must be Zip Code in which your credit card statement is mailed Fax: (909) 291-2107
For copy of receipt, please write email address: www.ca-nv-awwa.org

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