Workshop/Class Registration-ePay

Early Bird Rate--ePay
With this payment method, you will pay online through PayPal. You do not need a PayPal account to pay online; however, you can pay online using a PayPal account if you have one. Also, you can use a credit card or debit card (VISA, Master Card or Discover).

If you would rather use alternate payment methods, such as paying by check, paying with a credit card or debit card at the workshop/class, or invoicing, you need to use the Alternate Payment Method instead. If you want to pay using alternate methods, click here. You will be switched to the Alternate Payment Methods form.
Items with a * are required items

My workshop or class*

Water/Wastewater Workshop (For Small Systems, see below)$180.00

Participants

Water/Wastewater Long-term Class$1,850.00

Participants

Water or Wastewater Small Systems Workshop-One Day$90.00

Participants
Item subtotal:$0.00

Water -and- Wastewater Small Systems Workshop--Both Days-Package Deal$170.00

Participants

Enter coupon

Both SS Workshops begin
Water -AND- Wastewater Small Systems Workshops--Both Days-Package Deal
WWWATER Small Systems Workshop Registration and Payment--Special Package Deal*
Early Bird Rate

Billing Information
Bill to:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*

Confirmation EmailConfirm email
Add this email to your mailing list?*

Yes, add this email address to your list.No, I do not wish to receive info from you via email.

P1 begin
Registration Information Participant #1
Same info as Billing Information?*

YesNo
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail

Confirmation EmailConfirm email
Add this email to your mailing list?*

Yes, add this email address to your list.No, I do not wish to receive info from you via email.
Employer*
Example: City of Smallville, Arrowhead Boy Scout Camp, etc
Position*
Example: Operator, Administrator, etc.
Add or remove atendee #2

Add attendee #2Remove attendee #2

P2 begin
Registration Information Participant #2
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail

Confirmation EmailConfirm email
Add this email to your mailing list?*

Yes, add this email address to your list.No, I do not wish to receive info from you via email.
Employer*
Example: City of Smallville, Arrowhead Boy Scout Camp, etc
Position*
Example: Operator, Administrator, etc.
Add or remove atendee #3

Add attendee #3Remove attendee #3

P3 begin
Registration Information Participant #3
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail

Confirmation EmailConfirm email
Add this email to your mailing list?*

Yes, add this email address to your list.No, I do not wish to receive info from you via email.
Employer*
Example: City of Smallville, Arrowhead Boy Scout Camp, etc
Position*
Example: Operator, Administrator, etc.
Add or remove atendee #4

Add attendee #4Remove attendee #4

P4 begin
Registration Information Participant #4
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail

Confirmation EmailConfirm email
Add this email to your mailing list?*

Yes, add this email address to your list.No, I do not wish to receive info from you via email.
Employer*
Example: City of Smallville, Arrowhead Boy Scout Camp, etc
Position*
Example: Operator, Administrator, etc.
Add or remove atendee #5

Add attendee #5Remove attendee #5

P5 begin
Registration Information Participant #5
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail

Confirmation EmailConfirm email
Add this email to your mailing list?*

Yes, add this email address to your list.No, I do not wish to receive info from you via email.
Employer*
Example: City of Smallville, Arrowhead Boy Scout Camp, etc
Position*
Example: Operator, Administrator, etc.

I have read the workshop text-BEGIN
If you haven't read the text in red on the workshops page, click on this link to read it. It will open in a new window, so that when you are done, you can close the browser window, and you will be back here.

http://www.wwwater.org/workshops.html
I have read the text in red on the Workshops page of the website.

I have read the long-term text-BEGIN
If you haven't read the text in red on the long-term class page, click on this link to read it. It will open in a new window, so that when you are done, you can close the browser window, and you will be back here.

http://wwwater.org/longterm.html
I have read the text in red on the Long-term Classes page of the website.

I have read the long-term text-END
Click if you have read the text

YesNo
You will not be able to submit the form unless you agree that you have read the text above. When you click on SUBMIT, the form will be submitted, and you will be directed to the PayPal website, where you will complete the checkout process. You will receive the confirmation email after you have finished paying through PayPal.

Early Bird Rate--ePay