"*" indicates required fields ARWA Member* No Yes Name of Class*Please verify this is the correct class.Wastewater MicrobiologyDate of Class*Please verify this is the correct date of class.Attendee Name* First Last Company/Organization*Address* Street Address City State 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 ZIP Code Email* Phone*Does attendee have any special needs?* Yes No Please describe:*How many microscopes will you be bringing?*(WE NEED THIS INFO TO SET UP POWER SUPPLIES AND SET UP LAB SUPPLIES FOR YOUR MICROSCOPE)IT IS NOT MANDATORY TO BRING A MICROSPCOPE, HOWEVER WE CANNOT GUARANTEE ONE WILL BE AVAILABLE FOR YOU TO SHARE.If you have additional attendees, please list their first and last name here. One on each line.Class Fees Quantity*$175 per attendee, includes two days of lab. ($200 per attendee after March 10, 2025.) Enter total # of attendees below. Price: $175.00 Quantity Total Due How do you wish to pay?* Pay online now Pay by invoice Payment MethodPayPal CheckoutCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name
