Streamline - Summer 2011 - (Page 43)

Virginia Rural Water Association 2138 Sycamore Avenue, Buena Vista, Virginia 24416 Phone: (540) 261-7178 | Fax: (540) 261-2465 | Website: www.vrwa.org Membership Application Name of Organization: ____________________________________________________________ Contact Person (Delegate): _____________________________ Title: _______________________ Mailing Address: _________________________________________________________________ Physical Address: ________________________________________________________________ City/State/Zip: _________________________________________County: __________________ Phone: __________________________________ Fax: ___________________________________ Email: __________________________________________________________________________ All members are billed annually July 1st. Members joining after September will pay pro-rated amount for the remainder of the year. Please follow the charts below to determine your membership rate. Membership Type _____ Individual: _____ Class VI Operators _____ Corporate: _____ Associate: $75.00/yr. $150.00 $300.00 $300.00 Water/Wastewater (Based on #of Connections*) _____* Voting: $300.00/yr. 1-1000 Connection $350.00 1001-2000 $400.00 2001-3000 $450.00 3001-4000 $500.00 4001—up Total Amount Due: ________ _____# of Connections* Membership Categories: Voting: A non-profit, public entity serving a population of less than 10,000. This includes counties, county schools systems, service authorities, water & sewer departments and generally any non-profit system with board elected from within. Associate: A private or investor-owned utility or servicing a population of 10,000 or more. This includes state and federal agencies and other private utilities. Corporate: Entity that supports the water and/or wastewater industry. The annual membership fee is $300 for a parent company; $250 for each subsidiary; with a maximum umbrella of $1,000. Individual Member Join between Jul 1-Sept 30 = $75.00 Join between Oct. 1-Dec. 31= $56.25 Join between Jan 1-Mar 30 = $37.50 Join between Apr 1- Jun 30 = $18.75 Class VI Operator Member Join between Jul 1-Sept 30 = $150.00 Join between Oct. 1-Dec. 31= $112.50 Join between Jan 1-Mar 30 = $75.00 Join between Apr 1- Jun 30 = $37.50 Corporate & Associate Members Join between Jul 1-Sept 30 = $300.00 Join between Oct. 1-Dec. 31= $225.00 Join between Jan 1-Mar 30 = $150.00 Join between Apr 1- Jun 30 = $75.00 Voting -Water/Wastewater (Based on # of Connections) Join between Jul 1-Sept 30 Join between Oct. 1-Dec. 31 Join between Jan 1-Mar 30 Join between Apr 1- Jun 30 1-1000 1001-2000 2001-3000 3001-4000 4001-up $300.00 $350.00 $400.00 $450.00 $500.00 $225.00 $262.50 $300.00 $337.50 $375.00 $150.00 $175.00 $200.00 $225.00 $250.00 $75.00 $87.50 $100.00 $112.50 $125.00 Prorated Membership Dues Individual $_______ Class VI $_______ Corporate $_______ Associate $ _______ Voting $________# Connections ______ Total Amount Due = _________ Payment Information Payment Methods: Check: __________ Credit Card—Visa : ________ MC: ________(Make Checks payable to: VRWA) Card #: _____________________________ Expiration Date: __________ CID#: _________ (3-digit # on back of the card) Name as it appears on card: ___________________________________________________________ (Please print clearly) Billing Address: ___________________________________ City: _____________________ State: ______ Zip: __________ Signature: ______________________________________________________________________________ Email Address to send Receipt: ___________________________________________________________________ Total to be Charged: $ _________________ Check Number: __________ Total Amount Enclosed: $ ____________ Mail/Fax completed application to: Virginia Rural Water Association | 2138 Sycamore Avenue | Buena Vista, Virginia 24416 | Fax: (540) 261-2465 Questions? Call (540) 261-7178 or Visit www.vrwa.org www.vrwa.org 43 http://www.vrwa.org

Table of Contents for the Digital Edition of Streamline - Summer 2011

From the President
From the Executive Director
The Water Tastes Good in Western Virginia
Virginia WARN, Help in an Emergency
Uranium Mining
Proper Disposal of Pharmacy Products
VELAP: Where Are We Now?
Why Did the Paramecium Cross the Road?
Anger in the Work Place: What It Really Costs You
Litigation and Water Wars
Hydrant Flow Testing–Data You Need
What A Ride!
Conference 2011 Highlights
Throwing My Loop
eLearning Benefits
Membership Application
Do You Know What Your VRWA Benefits Are?
New VRWA Benefit
VRWA Mailbag
Welcoming New Members
Training Calendar
Board Of Directors
VRWA Committees
Index To Advertisers/ Ad.Com

Streamline - Summer 2011

http://www.nxtbook.com/nxtbooks/naylor/VRWQ0113
http://www.nxtbook.com/nxtbooks/naylor/VRWQ0412
http://www.nxtbook.com/nxtbooks/naylor/VRWQ0312
http://www.nxtbook.com/nxtbooks/naylor/VRWQ0212
http://www.nxtbook.com/nxtbooks/naylor/VRWQ0112
http://www.nxtbook.com/nxtbooks/naylor/VRWQ0411
http://www.nxtbook.com/nxtbooks/naylor/VRWQ0311
http://www.nxtbook.com/nxtbooks/naylor/VRWQ0211
http://www.nxtbookMEDIA.com