2023 Washington DC Roundtable Registration Step 1 of 2 50% The link to submit online payment via PayPal will be provided after completing this form. To pay by check or money order, please download and print this REGISTRATION FORM. No payment is required for complimentary registrations. Attendee Name* First Last Position/Title Company/Organization* Email* Phone Number*Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code April 4th 6pm-8pm: Joint Water Organization Reception I will attend I will NOT attend ICWP/NWSA Member – Registration (2 days, pre-paid before March 10th): Quantity Price: $450.00 Quantity Non-Member Quantity Price: $550.00 Quantity ICWP/NWSA Member (or paid after March 10th): Quantity Price: $550.00 Quantity Grand Sponsor – (1 complimentary registration and promotional opportunities) Quantity Price: $1,000.00 Quantity Complimentary Registration (ICWP Sustaining Members, federal agencies and speakers) Quantity Price: $0.00 Quantity Total $0.00 Conference RegistrationOnline Registration payment may be made via credit card or paypal. To mail in a check or money order please contact Beth Callaway (beth@ICWP.org).NameThis field is for validation purposes and should be left unchanged. Δ
