SCMA Workshop RegistrationOperator Troubleshooting & Hands-On TrainingAlamogordo, NM – April 23, 2020 "SCMA Operator Troubleshooting & Hands-On Training" WorkshopBrackish Groundwater National Desalination Research Facility (BGNDRF) | Alamogordo, NMThursday, April 23, 2020 | 7:30 am-4:45 pm (Space limited to 30 attendees) RegistrantPlease refrain from using all caps/uppercase letters, please use sentence structure letter case.Salutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast Name*Company*Job Title*Address*City*State*Zip/Postal Code*Country*USAAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweTelephone*CellEmail*Enter registered attendee's email address Website Special NeedsFood Allergies (describe below)Gluten Free MealsVegan MealsVegetarian MealsWheelchair AccessOther (describe below)Special Needs Comments Member of SCMA AMTA Billing Contact InformationEnter billing contact information, if applicablePlease be advised: SCMA has changed the mailing address to 2409 SE Dixie Hwy., Stuart, FL 34996Billing Contact NameBilling Contact EmailEnter billing contact's email address, if applicable Billing Contact Phone Please send copy of the invoice/receipt to Billing Contact Workshop RegistrationRegistration and Payment must be received by event date. To receive the early registration rate payment must be received on or before April 8, 2020.Today - Date Date Format: MM slash DD slash YYYY Early Workshop Registration*Members/Affiliates (must be from the list above), $175.00Non-Members - Certified Ops (includes 1 year Div.1B* SCMA membership), $225.00Non-Members - Non-Ops-Individual (incl. 1 year Div.3A SCMA membership), $275Please contact SCMA for membership application, or click here to apply for membership now.Workshop Registration*Members/Affiliates (must be from the list above), $225.00Non-Members - Certified Ops (includes 1 year Div.1B* SCMA membership), $275.00Non-Members - Non-Ops-Individual (incl. 1 year Div.3A SCMA membership), $325Please 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 AssociationMail to: 2409 SE Dixie Hwy., Stuart, FL, 34996. Comments/QuestionsComments Cancellations/RefundsWritten cancellation requests received on or before April 9, 2020 will receive a refund, less a $50 processing fee. Full payment is required if cancellation is received on or after April 10, 2020 - 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. SCMA Workshop in collaboration with SWMOA Workshop SCMA’s Workshop is held in collaboration with SWMOA’s MBR Workshop at the Village of Cloudcroft Wastewater Treatment Plant on April 22, 2020. Click here for more information on the SWMOA MBR Workshop Registration will be available shortly. CAPTCHAPlease refer to SCMA’s Privacy Policy if you have any questions regarding your preferences.NameThis field is for validation purposes and should be left unchanged.