Membership Application Form

Please complete and submit this form. You will be contacted to finalize the membership application process. Thank you for your interest in joining the Alliance for Water Efficiency. 


Type of Membership - Please select category and provide the accompanying information. Click category name for dues information.

 

Water volume sold annually in MGD:  

Wastewater Agency..............Wastewater processed & treated annually in MGD:  

Annual revenue:  

  

Association...........................................................Number of members in association:  

Affiliate..................................................................................Annual operating budget:  

Government...........................................................Indicate type of Government entity:  

Individual  (unaffiliated citizen, information-only) 


Length of Membership - Please select one of the three options.

 

 

 


Contact Information

 

Organization:  

Primary Contact Name: * 

   Job Title:  

   Phone: *     Fax:  

   E-mail: * 

Alternate Contact Name: * 

   Job Title:  

   Phone: *     Fax:  

   E-mail: * 

Address: * 

City: *    State: * 

Zip code: *    Country:   

Web site address:  

*Required Field 


If applicable, please provide the following information. --We would love to thank them for their support of the Alliance.

"I was encouraged to join the Alliance for Water Efficiency by..."  

Referral Contact Name:  

   Organization:  

   E-mail: