Ohio American Water Works Association (Ohio AWWA)

Ohio Water Environment Association (Ohio WEA)

Student Application Form

Preferred Mailing Address (circle one)          School                  Home

Mr.

Ms.

Mrs.

Dr.

Name

Street Address

P.O. Box or Mail Stop

City/State/Zip or Postal Code

Name of College/University

Name of Sponsor (Person who gave you this form)

Please furnish home mailing address if above address is your school address, or school mailing address if above address is your home address:

Street Address

P.O. Box or Mail Stop

City/State/Zip or Postal Code

School Phone

(           )

Home Phone

(           )

Fax Number

(           )

School E-mail Address

Home E-mail Address

Preferred E-mail Address (circle one)            School                Home

Your Annual Dues are $30 to join both organizations: National AWWA and National WEF.  The state organizations [i.e., Ohio AWWA and Ohio WEA] will pay the difference in the national dues for their respective organizations.

When paying with check, write one $20 check payable to the American Water Works Association and a second $10 check payable to the Water Environment Federation.

Please submit your $30 dues, this completed form, and completed National AWWA and WEF Membership Applications (which can be downloaded from www.awwa.org and www.wef.org, respectively) to either person listed below:

Gunilla Goulding

Malcolm Pirnie

8790 Governor’s Hill Drive, Suite 101

Cincinnati, Ohio  45249-1374

(513) 677-6862

ggoulding@pirnie.com

Alison Gusses Dugan

USEPA; TSC (MS140)

26 W. Martin Luther King Dr.

Cincinnati, OH  45268

(513) 569-7122

dugan.alison@epa.gov