Convention EXHIBITOR Registration Form 2023 2023 Convention Orlando, FL "*" indicates required fields Step 1 of 5 - FWQA Membership 20% FWQA MembershipAre you a member of FWQA?* Yes No Please Pick Your FWQA Membership*-- select a Member --3Waters FL LLCA-2-Z Water Systems IncAbsolute Water Management - EcoWaterAction Manufacturing & SupplyAdvance Water Systems IncAdvanced Water ProductsAdvanced Water Systems, Inc.Advanced Water Technologies IncAerus LLCAffordable CondtionersAffordable WaterAffordable Water & Coffee ServiceAL Water Treatment Installation, LLCAlbert Soft WaterAll American Purification LLCAll Florida Soft WaterAll Star Plumbing & DrainAll-Rite Water PurificationAllini Water Filters of FloridaAO Smith Water Treatment (NA) Inc, Hague Quality WaterAQMaticAqua Care Water Treatment & PlumbingAqua FinanceAqua Guru , LLCAqua Plumbing & Air Services IncAQUA SOFT REFINED WATER INC.Aqua SolutionsAqua WholesaleAquaflow LLCAquakleen Products IncAquamundoAquasun LLCAqueous Solutions GlobalArrow Industries Division of Elbi of AmericaArt Plumbing, AC & ElectricAshberry Water ConditioningAtlantic Filter CorpAtlantic Filter of Polk CountyAtlantis Filter LLCAvoda Water SolutionsBalanced Water and Drain ServicesBest Water Solutions, Inc.Bluewater USA, IncBrita ProBush Services Inc.C-Tech Water SolutionsCaptain FiltrationCargill SaltCastle Credit Co Holdings, LLCCertain Services IncCGC Water -/ Northeast Florida Water LLCCharger Water Treatment - JacksonvilleCharger Water Treatment - OdessaChowder FinancialClack CorporationClean Water AmericaCLEAR WATER TREATMENTClearwater SoftenersCoast Pump Water TechnologiesCoastal Energy Water & Air- Rainsoft Distributor EastCoastal Energy Water & Air- Rainsoft Distributor WestComplete Water SystemsCon-Serv Mfg.Crystal Clear Water Purification IncCRYSTAL WATER SYSTEMS INCCulligan Melbourne/ Daytona BeachCulligan Water Ft. MyersCulligan Water Services - Kingsland GADarrel's PlumbingDataman Group DirectDiscount Water SupplyDOMERS INCDyco WaterEast Coast Well, Pump & Water TreatmentEcoWater of North Florida/ Sunshine State Water LLCEcoWater of TampaEd's Wells & Pumps IncEnpress LLCEnvironmental World Products LLCEvergaldes Laboratories, IncFargo Well and Pump Services IncFCT Water FloridaFilter Pure Systems, Inc.Filter Pure Systems, Inc.Filtration PartsFinal Filter LLCFlorida Pump ServiceFlorida Water Consultants, LLCFlorida Water TechnologiesFloTrol International LLCFluid Systems and ControlsFoundation FinanceFritton Water IncFSHSG.A. MURDOCKGenesis Environmental Tecnologies, Inc/ Tri Star Marketing and Distributing LLCGet Water AnswersGetWaterAnswers.comGlobematicGolden Gate Well DrillingGood Marketing GroupGorman Company/ HajocaGrid Controls LLCGuardian Water ServicesGulf Coast Water Conditioning IncGW Pumps & PurificationH2O Florida LLCH2O InternationalH2O Systems IncH2O Water ProsHarrington Industrial PlasticsHealthy Water Systems, LLCHome Supply & Services LLCHydrenesis, IncHydro Medix Technologies Inc.Hydrotech-A division of Canature WaterGroupIG Water Treatment InternationalIntegrity Water Treatment LLCITZGOOD H2O HEALTHY SOLUTIONSJ.C. GALLOWAY, THE WATER DOCTOR, INC.Jax Water Conditioning IncJB Water TreatmentJohn Guest USA/ RWCK & R Water Service IncKenai CollectionKey Salt and WaterKineticoKinetico water systems of SW FLLamplight Digital Media, LLCLand O Lakes ( Crocker Water)Leaf Home Water SolutionsLiquid Soap ProductsMiami Alkaline WaterMJHS, LLCMorton SaltMr. Rooter PlumbingMr.Water CompanyMy Innovation Products,LLCNelsen CorpNew Wave WaterNorth South Supply IncNothing But WaterNuco Pump & Well Services LLCPalm Beach Water PurificationPentair WaterPhase 2 Smart Water SolutionsPinnacle Express, IncPortasoft WaterPrecision Installation Products IncPremier Water PurificationPro ProductsPure and Gentle SoapPURE FLOW WATER PRODUCTSPure Liquid Water, LLCPure Touch Water Filters IncPuronics Water Systems, IncQuantum Leap Sales Meetings & Training LLCR & S Softwater Service IncReps H2OResinTechSafeway Water LLCSayler's Suncoast WaterScotwood Industries LLCSeamans Aqua CleanSeminole Tribe of FloridaSensible Water Solutions LLCSheffield's Pump Service LLCSilver King Water TreatmentSimpleWater Inc.Simply Soft WaterSonomo County SoapSouthern Water Services IncStenner Pump CompanySundial Inc.SWFL Hydrology IncT & K Water ConditioningTHE LEVEREDGEThe Water ExpoThermaxUnited DistributorsVery Well Water LLCVIP Water Filtration and IrrigationVolteaWater ExpertsWater Genius Systems IncWater Medic of Cape Coral, Inc.Water Technology ResourcesWater Treatment and Filtration LLCWater Treatment WarehouseWater-ProWATER-RIGHT, INC.WaterColor ManagementWaterite – Franklin Water TreatmentWaterman CompanyWaterTech IncWATTSWest Coast Plumbing & Water Treatment LLCXcell Water ConditioningWould you like become a member of FWQA and save on today's registration?**An FWQA membership is $175 and will be added to today's total. The membership includes more than a 25% discount off of the registration rate for the FWQA Convention, among other benefits YES! Please add membership and start saving now No thank you. FWQA Membership InformationName* First Last Email* Phone*Company* Address* Street Address Address Line 2 City 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 State ZIP Code Total Exhibitor Tables & BoothsAll-in-One Member-Exclusive Sponsorship*See the amazing perks by clicking each All-in-One Sponsorship. All-in-One Platinum Sponsorship ($3,750) All-in-One Gold Sponsorship ($3,250) All-in-One Silver Sponsorship ($2,450) NO All-in-One (NO CHARGE) HiddenI would Like to ADD an ADDITIONAL Booth or TableAdd an ADDITIONAL BOOTH or TABLE space. You already receive ONE with your All-In-One. Yes, Add additional space No additional exhibit space is needed 1. Platinum Level Sponsorship ($2000 value) 2. One (1) 8x10 Foot Booth ($1200 value) 3. One Foursome for Golf Tournament ($600 value) 4. One Golf Hole Sponsorship ($125 value) 5. Includes: ½ page ad (B&W) OR add color to a 1/4 page ad at no additional charge ($200 value) 1. Gold Level Sponsorship ($1500 value) 2. One (1) 8x10 Foot Booth ($1200 value) 3. One Foursome for Golf Tournament ($600 value) 4. One Golf Hole Sponsorship ($125 value) 5. Includes: ½ page ad (B&W) OR add color to a 1/4 page ad at no additional charge ($200 value) 1. Silver Level Sponsorship ($1000 value) 2. One (1) 6 Foot Tabletop ($850 value) 3. One Foursome for Golf Tournament ($600 value) 4. One Golf Hole Sponsorship ($125 value) 5. Includes: ½ page ad (B&W) OR add color to a 1/4 page ad at no additional charge ($200 value) Ok, maybe next year. But you could be missing out!If you would like any additional booth or table space in addition to your All-in-One package, please select it below. Otherwise, leave these fields at '0'All-in-One Booth (INCLUDED)Each 8' x 10' booth space includes 2 registrations, 1 trash can, and 2 chairs. Price: All-in-One Table (INCLUDED)Each 6' x 30" table top (1-40) includes 2 registrations, 1 trash can, and 2 chairs. Price: What Type of Exhibit Space Would You Like? Booth Exhibit Table BOTH How many exhibitor booths would you like?Each booth is $1,200 EACH. Each 8' x 10' booth space includes 2 registrations, 1 trash can, and 2 chairs. Each booth exhibitor package purchase includes a 1/4 page advertisement in the FWQA Directory.1 Booth2 Booths3 BoothsHow many exhibitor tables would you like?Each table is $850 EACH. Each 6' x 30" table top (1-40) includes 2 registrations, 1 trash can, and 2 chairs. Each table top exhibitor package purchase includes a 1/4 page advertisement in the FWQA Directory.1 Table (M)2 Tables (M)3 Tables (M)How many exhibitor tables would you like?Each table is $1,050 EACH. Each 6' x 30" table top (1-40) includes 2 registrations, 1 trash can, and 2 chairs. Each table top exhibitor package purchase includes a 1/4 page advertisement in the FWQA Directory.1 Table (NM)2 Tables (NM)3 Tables (NM)Total Is the primary FWQA Member attending? Yes No Member InformationPrimary FWQA Member Name* First Last Primary FWQA Member Email* Primary FWQA Member Phone* Exhibitor Attendee #1 Registration Information(Booth/Table #1) Each booth/table receives 2 attendee badgesExhibitor Attendee #1 is Primary MemberName* First Last Email* Phone*Exhibitor Attendee #2 Registration Information(Booth/Table #1) Each booth/table receives 2 attendee badgesName First Last Email PhoneExhibitor Attendee #3 Registration Information(Booth/Table #2) Each booth/table receives 2 attendee badgesName First Last Email PhoneExhibitor Attendee #4 Registration Information(Booth/Table #2) Each booth/table receives 2 attendee badgesName First Last Email PhoneExhibitor Attendee #5 Registration Information(Booth/Table #3) Each booth/table receives 2 attendee badgesName First Last Email PhoneExhibitor Attendee #6 Registration Information(Booth/Table #3) Each booth/table receives 2 attendee badgesName First Last Email PhoneAdditional Attendee RegistrationDo you need to add additional convention registrations?*You receive two complimentary convention registrations with your table top package. Yes No How Many Additional Attendees? Quantity Price: $75.00 Quantity Please Include the Names and Emails of Any Additional RegistrationsPlease use the (+) to add a rowNameEmail Add RemoveTotal Advertising UpgradeEach table top exhibit display package comes with a 1/4 page advertisement in the FWQA Directory. You may choose to upgrade below if you wish.All-in-OneAdvertising UpgradeIncludes: ½ page ad (B&W) OR add color to a 1/4 page ad at no additional charge ($200 value)UPGRADE OPTION*Includes: ½ page ad (B&W) OR add color to a 1/4 page ad at no additional charge ($200 value) Use 1/2 Page Ad (Included) 1/4 Page Ad with COLOR Would You Like to Add Color? ADD Color NO Color HALF Page Directory Ad: $175Would You like a directory Ad? (7 1/2" x 10") YES, Half Page NO Half Page Would You Like to Add Color? ADD Color NO Color FULL Page Directory Ad: $300Would You like a directory Ad? (7 1/2" x 10") YES, Full Page NO Full Page Would You Like to Add Color? ADD Color NO Color UPGRADE: FULL Page Directory Ad: $100Would You like a directory Ad UPGRADE? (7 1/2" x 10") (Includes a $200 Ad Credit) YES, Full Page Upgrade NO Full Page Upgrade Would You Like to Add Color? ADD Color NO Color INSIDE BACK Cover Directory Ad: $385Would You like a directory Ad? (7 1/2" x 10") YES, Inside Back Cover NO inside Back Cover Would You Like to Add Color? ADD Color NO Color UPGRADE: INSIDE BACK Cover Directory Ad: $185Would You like a directory Ad? (7 1/2" x 10") YES, Inside Back Cover NO Inside Back Cover Would You Like to Add Color? ADD Color NO Color INSIDE FRONT Cover Directory Ad: $400Would You like a directory Ad? (7 1/2" x 10") YES, Inside Front Cover NO Inside Front Cover Would You Like to Add Color? ADD Color NO Color UPGRADE: INSIDE FRONT Cover Directory Ad: $200Would You like a directory Ad? (7 1/2" x 10") YES, Inside Front Cover NO Inside Front Cover Would You Like to Add Color? ADD Color NO Color OUTSIDE BACK Cover Directory Ad: $620Would You like a directory Ad? (7 1/2" x 10") YES, Outside Back Cover NO Outside Back Cover Would You Like to Add Color? ADD Color NO Color UPGRADE: OUTSIDE BACK Cover Directory Ad: $420Would You like a directory Ad? (7 1/2" x 10") YES, Outside Back Cover NO Outside Back Cover Would You Like to Add Color? ADD Color NO Color Two Page Centerfold Directory Ad: $900Would You like a directory Ad? (15" x 10") YES, Inside Centerfold NO Inside Centerfold Would You Like to Add Color? ADD Color NO Color UPGRADE: Two Page Centerfold Directory Ad: $700Would You like a directory Ad? (15" x 10") YES, Inside Centerfold NO Inside Centerfold Would You Like to Add Color? ADD Color NO Color Total File UploadLogo Upload - Please make a selection Upload my logo Use my previously provided logo FileMax. file size: 32 MB.Advertisement Upload - Please make a selection Upload my ad now Use my previously provided ad I'll send my ad later FileMax. file size: 32 MB.IMPORTANT! Advertisements for the 2022 FWQA Convention are due by May 12, 2023Exhibitor ListingPlease Use My Exhibitor Listing form 2022* Yes, Use my 2022 Exhibitor Listing No, I would Like a New Listing Please Give Us Your Exhibitor Program Listing DonationWould you like to donate to the Florida Committee on Water Quality?* Yes No Donation amount LEVEL 1 Donor: $25.00 LEVEL 2 Donor: $50.00 LEVEL 3 Donor: $100.00 LEVEL 4 Platinum Donor: $250.00 Your Donation Amount Your amount Total CostTotal Credit Card*Card Details Cardholder Name Email Confirmation / Receipt*
