Pacific Water Quality Association

Membership Application

* Required

BUSINESS DETAILS:

Company Name:

*

Street Address:

*

City:

*

State:

*

Zip Code:

*

Phone:

*

Fax:

Email:

*

Website:

(exclude http://)

Description of Company:


REPRESENTATIVE #1 DETAILS:

Name:

Title

Street Address:

City:

State:

Zip Code:

Phone:

Fax:

Email:


REPRESENTATIVE #2 DETAILS:

Name:

Title

Street Address:

City:

State:

Zip Code:

Phone:

Fax:

Email:


I AGREE WITH THE FOLLOWING STATEMENT:

Checking this box reflects a corporate decision that this company will abide by the Voluntary Guidelines and Code of Ethics promulgated by WQA and endorsed by PWQA.

Click here to open code of ethics form


DUES GUIDELINES:

Prorated Dues are based upon calendar days remaining in the year. In January of the next calendar year you will be invoiced at the amount you note below.

SELECT ONE:

Up to $250K
Semi-annual payment of 187.98 or annual payment of $365.00

$250001 - $500K
Semi-annual payment of $321.36 or annual payment of $624.00

$500001 - $750,000
Semi-annual payment of $535.60 or annual payment of $1,040.00

$750,001 - $1,000,000
Semi-annual payment of $749.33 or annual payment of $1,455.00

$1,000,001 - $1,500,000
Semi-annual payment of $880.65 or annual payment of $1,710.00

500,001 - $2,000,000
Semi-annual payment of $1,011.46 or annual payment of $1,964.00

$2,000,001 and above
Semi-annual payment of $1,133.00 or annual payment of $2,200.00



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Pacific Water Quality Association

PO Box 3959
Mission Viejo, CA 92690-3959

Phone: 760-644-7348
Fax: 714-242-7715