Water Well Journal

October 2016

Water Well Journal

Issue link: http://read.dmtmag.com/i/728580

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Page 45 of 90

Four easy ways to register 1. Online: GroundwaterWeek.com 2. Phone: (800) 551-7379 or (614) 898-7791 outside the United States 3. Fax: (614) 898-7786 4. Mail: NGWA, 601 Dempsey Rd., Westerville, OH 43081-8978 USA Mail-in deadline: November 4, 2016 6010dec16-09 Las Vegas∙Dec. 6-8, 2016 SM DEMOGRAPHIC INFORMATION (please mark one) Water well contractor/pump installer Scientist/engineer/hydrologist Supplier/distributor/wholesaler Manufacturer representative Manufacturer (nonexhibiting) Student (school name and ID#) _________________________ By virtue of registering to attend this NGWA event, you grant NGWA full rights to use any photos/videos/recordings containing your likeness taken during the routine business course of the event, by NGWA or its official representatives, to be used in any future promotional endeavors of NGWA and its affiliates, without any further notification or expectation of compensation. Team discount: Save 15% per person on regular Groundwater Week registration fees when you register three or more at the same time. To take advantage of this discount, you need to register by phone — (800) 551-7379 or (614) 898-7791 outside the United States — and all registrations must be made at the same time with total payment submitted to qualify. Refund policy — a $25 cancellation fee per registrant applies to all refund requests made on or before November 4, 2016; no refunds will be issued on or after November 5, 2016. REGISTRATION TYPE Groundwater Week registration fees per person U.S. FUNDS NGWA member $150 $250 NGWA member spouse $150 $250 Nonmember $275 $375 Nonmember spouse $275 $375 Student—full-time (ID required) $35 $55 Manufacturer (nonexhibiting) $1,200 $1,200 first registrant Manufacturer (nonexhibiting) $300 $300 additional registrant Optional educational offerings I The prices listed here are only available to Groundwater Week attendees. I If you are not attending Groundwater Week, please register online at NGWA.org or by calling NGWA customer service at (800) 551-7379 or (614) 898-7791. Groundwater/Surface Water Interactions: Tools and Technologies to Evaluate a Complex Environmental and Regulatory Setting (#242), December 5-6 NGWA member $445 $545 Nonmember $595 $695 Direct Push Technology — Stronger than Ever…and Cost-Effective, too (#339), December 9 NGWA member $345 $445 Nonmember $495 $595 Hydrogeochemical Processes Controlling Metals Remediation of Aquifer Systems (#156), December 9 NGWA member $345 $445 Nonmember $495 $595 Grand total $______________________ on/before Nov 4 starting Nov 5 Registration form REGISTRATION INFORMATION NAME AS IT SHOULD APPEAR ON BADGE Job title NGWA membership # if applicable Employer name Mailing address City State/Province Country Zip/Postal code Telephone Fax Email Please print legibly or type information, using one form per person. Be sure to clearly check all appropriate boxes regarding fees. CHILDREN UNDER 17 FREE REGISTRATION (please list any child under the age of 17 that will be attending) ____________________________________ __________________________________ ____________________________________ __________________________________ ____________________________________ __________________________________ PAYMENT INFORMATION GRAND TOTAL U.S. FUNDS $ _________________________________ METHOD OF PAYMENT: ❑ Check or money order payable to NGWA, # _________________________________ Charge: ❑ MasterCard ❑ Visa ❑ American Express ❑ Discover Company card? ❑ Yes ❑ No Card # Expiration date Cardholder's name Signature Baroid Industrial Drilling Products is the ocial sponsor of the Groundwater Week on-site registration and welcome areas. Las Vegas∙Dec. 6-8, 2016 SM Twitter @WaterWellJournl WWJ October 2016 41

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