TGWA MEMBERSHIP APPLICATION FORM

This form sends your membership application to TGWA via e-mail. Alternatively, you may print and return the form to TGWA by fax to (512) 472-0537 or by mail to 221 East 9th Street, Suite 206, Austin, Texas 78701.

Name:
Organization:

Mailing address:
City: State: Zip:

Phone:
Fax:
E-mail:

Membership Categories:
* Contractor, driller, or pump installer company	$175
* Manufacturer or supplier company	$150
* Ground water science division company, entity, or association	$80

* The above memberships include two additional individuals from your organization.

2nd member:
Mailing address:

3rd member:
Mailing address:

Individual driller, contractor, or pump installer	$125
Individual manufacturer, supplier, or manufacturer representative	$60
Individual ground water science division member	$30
Individual registered driller/technician (must be employed by a company member)	$30
Individual associate (any person not qualified under any of the above categories)	$30
Individual student membership (must be enrolled in school, college, or university)	$10

Upon receiving this registration form, TGWA will call or e-mail you to confirm your application, then send an invoice to the address you provided.