Online Membership Form February 28, 2020 Company Name*Address* Street Address Address Line 2 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 CountyTelephone*FaxWebsite Address# of Meters (or population served)Indiana Utility Regulatory Commission (IURC) Member Yes No Type of Business*Joining as an Associate Member?* Yes No If joining as an Associate Member, please provide a description of your services/products.*Contact Person* First Last Contact Person Email Water Operator First Last Water Operator Email Wastewater Operator First Last Waterwater Email Additional Contact First Last Additional Contact Email Water & Wastewater Utilities 1 - 300 meters (approx. 3 to 750 population) - (Price $100.00) 301 - 600 meters (approx. 751 to 1500 population) - (Price $140.00) 601 - 1000 meters (approx. 1501 – 2500 population) - (Price $190.00) 1001 - 1500 meters (approx. 2501 – 3750 population) - (Price $245.00) 1501 - 3000 meters (approx. 3751 - 7500 population) - (Price $320.00) 3001 meters and above (approx. 7501 population and above) - (Price $420.00) (one vote per utility) Number of Meters in operation (or approximate population served) as of January 1 of each year. Non-Community Water Systems Quantity Price: $90.00 Quantity Annual Dues (one vote per system)Associate Membership Quantity Price: $300.00 Quantity Vendors (Non Voting) Combined Membership Quantity Price: $685.00 Quantity Corporate with Multiple Facilities (call IRWA office to check applicability)Total $0.00 Subtotal Options Total Add to cart
