Utility Membership Application

This is an application. Once your application has been reviewed, we will mail you an invoice for your membership dues.

Use this application if you are a water supply corporation, city, district, IOU, etc.

Annual Dues: $1.15 per water meter

(Minimum: $385, Maximum: $4,750)

System Name (required):

Number of Water Meters (required):

Number of Wastewater Meters (required):

Regular member dues (required):

Type of Membership:
 New Renewal

Water Source:
 Groundwater Surface water Combination Purchase only

Type of ownership:
 Nonprofit water supply corporation Utility District Municipality Investor-owned utility

Mailing address (required):

City: State: Zip:

County (required):

Physical address (if different):

City: State: Zip:

Directions to system:

Phone number (required):

Fax number:

Contact e-mail address (required):

Company website:

State senator:

State representative:

System Contacts

Please include the name, phone number, email address and mailing address for the following officers and employees. Up to date addresses and phone numbers will ensure that the TRWA magazine and information will be received. TRWA does not sell e-mail addresses.

President
Name:
Phone:
E-mail:
Mailing address:

Vice President
Name:
Phone:
E-mail:
Mailing address:

Secretary
Name:
Phone:
E-mail:
Mailing address:

Treasurer
Name:
Phone:
E-mail:
Mailing address:

Director
Name:
Phone:
E-mail:
Mailing address:

Director
Name:
Phone:
E-mail:
Mailing address:

Director
Name:
Phone:
E-mail:
Mailing address:

Director
Name:
Phone:
E-mail:
Mailing address:

Director
Name:
Phone:
E-mail:
Mailing address:

Manager
Name:
Phone:
E-mail:
Mailing address:

Operator
Name:
Phone:
E-mail:
Mailing address:

Bookkeeper
Name:
Phone:
E-mail:
Mailing address:

Other
Name:
Title:
Phone:
E-mail:
Mailing address: