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| Rural Water Association of Arizona
Rural Water Association of Arizona
1075
South Idaho Road, Suite #213 Apache Junction, AZ 85119, Phone (480) 982-0301, Fax (480) 982-0278
Any individual, firm, corporation, or organization adhering to the purposes of the Association and desiring
to assist in the work of the Association may become an associate non-voting member and will receive its
quarterly magazine.
ASSOCIATE MEMBERSHIP
Application / Renewal Form
(
Water and Wastewater Systems please use the System & Individual Members Form)
Check # ___________________ VISA _ ________________ MasterCard _ __________ Discover _______________ American Express ___________________
Card # _ ________________________________________________________________________ Exp. _ _____________ Card Verification Code _ _________________
Name on Credit Card _ ___________________________________________________________________________________________________________________________
Cardholder Signature _ ___________________________________________________________________________________________________________________________
Make checks payable to:
Rural Water Association of Arizona
Providing the highest quality training and technical assistance to rural
water and wastewater utilities throughout Arizona, and representing
the legislative and regulatory interests of our members.
PAYMENT INFORMATION
Association Member Dues:
$400
Company / Organization Name ______________________________________________________________________________________________________________
Street Address ___________________________________________________ City ____________________________ State ______________ Zip _________________
Contact Name _ ___________________________________________________________ Title ______________________________________________________________
Email ______________________________________________Company Website _ ______________________________________________________________________
Phone ______________________________________________________________ Fax ________________________________________________________________________
Please check as many of the categories below that apply to your company’s products and/or services. This information is for the
online RWAA Associate Member Directory. Your company can name multiple listings in the Category Index, a quick reference tool
for potential customers shopping for your product or service.
Aeration
Arsenic Removal & Testing
Automatic Flushing
Cathodic Protection/Corrosion Control
Chemicals
Clamps
Coatings & Linings
Computers/Software/Technology
Controls/Controllers
Data Communications
Disinfection, Cleaning & Removal
Distribution
Filters/Filtration
Hydrants
Instrumentation/Monitoring Devices
Laboratory & Testing
Leak Detection
Management Systems
Meters & Meter Reading
Ozone Equipment & Instrumentation
Pipes & Fittings
Process Control Data
Professional Services
Pumps
Remediation
Safety/Security
Tanks
Treatment Plant Systems
Valves
Water & Wastewater Management
For Association Use Only:
Date Received _ _______________________
Follow-up _____________________________