SCMA Workshop Registration – Broken Arrow, OK – April 10, 2018 "Low Pressure Membrane Operations & Troubleshooting" WorkshopVerdigris River Water Treatment Plant | Broken Arrow, OKTuesday, April 10, 2018 | 8:00 a.m. - 4:45 p.m. (Space limited to 30 attendees) RegistrantSalutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast Name*Company*Job Title*Address*City*State*Zip/Postal Code*Country*Telephone*CellFaxEmail* 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)Website Special Needs Food Allergies (describe in comments) Gluten Free Meals Halal Meals Vegan Meals Vegetarian Meals Wheelchair Access Other (describe in Comments) Workshop RegistrationRegistration and Payment must be received by event date. To receive the early registration rate payment must be received on or before March 23, 2018.Today - Date Date Format: MM slash DD slash YYYY Early Workshop Registration*Members, $150.00Non-Members, $200.00For other types of membership - please contact SCMA for membership application, or click here to apply for membership now.Workshop Registration*Members, $200.00Non-Members, $250.00For other types of membership - please contact SCMA for membership application, or click here to apply for membership now. Need Contact Hours?*Yes, Contact Hours for Water/WastewaterNo Contact Hours RequiredLicense State*License Type*License Level*License #* 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., Ste. 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 Address* Comments Cancellations/RefundsWritten cancellation requests received on or before March 23, 2018 will receive a refund, less a $50 processing fee. Full payment is required if cancellation is received on or after March 24, 2018 - no refunds and no credits for future events will be granted. However, substitutions may be made at any time. SCMA reserves the right to make changes in programs and speakers, or to cancel programs when conditions beyond its control prevail. Every effort will be made to contact each enrollee if a program is cancelled. If a program is not held, SCMA’s liability is limited to the refund of the program fee only. Final Step of Registration ProcessPlease enter the letters displayed above to complete your application and then click Submit.NameThis field is for validation purposes and should be left unchanged.