Membrane Plant Operator Training Registration – MOC I: Introduction to Membrane Systems – Sugar Land, TX City of Sugar Land Surface Water Treatment PlantSugar Land, TXTuesday-Thursday | Sept. 25-27 RegistrantSalutation*Mr.Mrs.Ms.Dr.First Name*Last Name*Company*Job Title*Address*City*State*Zip/Postal Code*Country*Telephone*CellFaxEmail* Website Communication and Data Sharing PreferenceSCMA has been diligent in Data Security and being compliant with US and other Nations regulations.Email Notifications*Yes, I authorize receiving publication email notificationsNo, I would not like to receive publication email notifications (opt-out)Authorization for receiving publication email notification from SCMA. (applies to all email addresses on this form)Data Sharing*Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with SCMA Board, Event Sponsors, Speakers, Moderators & Attendees.Opt-Out: Do not share my contact information. Outside of SCMA Administration, only my name, title and company will be shared with SCMA Board, Event Sponsors, Speakers, Moderators & Attendees. License #*License State*License Type*License Grade* Special Needs Food Allergies (describe in comments) Gluten Free Meals Halal Meals Vegan Meals Vegetarian Meals Wheelchair Access Other (describe in Comments) Membrane Operator CertificationStudents must have attended a basic water class or equivalent or be working as an employee of a Water/Wastewater Public Agency, Industrial Water/Wastewater Users, or Water Suppliers to End Users (submit proof).(Non-Certified Operators who pass the Exam are not eligible to receive a Membrane Operator Certification)The registration fee includes CEUs/PDHs and the shipment of the MOC Manual to the address listed above upon receipt of payment. If an alternate address for shipment is requested, please provide the preferred shipment address below or by calling SCMA at 512-617-6529. If payment is not received within five (5) business days of the school, the MOC Manual will be provided the first day of class and upon receipt of payment. *Limited Space - Registration Reserved ONLY Upon Receipt of Payment and Availability MOC-I Registration (Sept. 25-27)*Members/Affiliates (must be from the list above), $375No Class Required, Exam OnlyNon-Members - contact SCMA to become a member prior to registering for this Training or click here to apply for membership now.MOC-I Exam Registration (Sept. 27)*Exam, $25No Exam RequiredShipping MOC Manual to a different address?*Yes, Ship to a different address than listed aboveNo, Ship to the same address listed aboveAlternate Address for the Delivery of the MOC Manual: If the shipment of the MOC Manual is to an alternate address, please provide it here. Please note that a signature is REQUIRED upon delivery (price included).Shipping Address for MOC Manual* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Total Registration Fee $0.00 Payment InformationPayment Method*Credit Card - Online PaymenteCheck (Bank Wire w/o processing fee) - Online PaymentCheckInvoiceIf paying by check, make payable to: South Central Membrane Association, and mail to: 14900 Avery Ranch Blvd., Suite C200 #300, Austin, TX 78717. Comments/QuestionsIf you would like a copy of the invoice/receipt sent to another*Yes, send copy of invoice/receipt to:No, don't need a copy sentIf yes, you would like a copy of the invoice/receipt sent to another other than the attendee please enter information below.Name* First Last Email* Comments Cancellations/RefundsWritten cancellation requests received by the South Central Membrane Association (SCMA) at least 14 days before a scheduled event will receive a refund, less a $50 administrative processing fee upon return receipt to SCMA office of the unaltered MOC Handbook for each Module. Without return receipt of the unaltered MOC Handbook(s) the cancellation fee will be $200 for each Module (includes administrative processing fee and handbook fee). Full payment is required if the request is received less than 14 days of the scheduled event and no refund will be available. A substitution of the registrant may be made any time without cost up to the date of the event. The requested amount of a refund must exceed their respective administrative processing fees as described above in order to be considered. SCMA reserves the right to make changes to the scheduled event including but not limited to changing the event location, scheduled date(s), program and speakers, or to cancel the event in its entirety when conditions beyond its control prevail. If the event is cancelled, SCMA’s liability is limited to providing a full refund of the fees paid toward the scheduled event. CAPTCHA