The Florida Water Quality Association (FWQA) is the premier group representing professionals who seek to improve the health, safety, and quality of water used by consumers, small businesses, and industry.

Become a member of FWQA!

Please fill out the form below to become member of FWQA!

FWQA Member Information

Name*

First Last

Email*

Phone*

Company*

Address*

Street Address Address Line 2 City State ZIP Code

Additional Names & Emails

Is there anyone else at your company that you would like to have receive email communications from FWQA? If so, please list their name and email address below.

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Donation

Would you like to donate to the Florida Committee on Water Quality?*

Yes

Donation amount

Bronze: $25.00

Silver: $50.00

Gold: $100.00

Platinum: $250.00

Total Cost

FWQA Membership

Price:

Total

Credit Card

Card Details

Cardholder Name

Please fill out the form below to sign up for our Education Seminar.

FWQA Membership

Are you a member of FWQA?*

Yes

Please Pick Your FWQA Membership*

Would you like become a member of FWQA?*

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 Fall Education Seminar, among other benefits

Yes

FWQA Membership Information

Name*

First Last

Email*

Phone*

Company*

Address*

Street Address Address Line 2 City State ZIP Code

Registration

Who are you registering for?*

Myself

Myself AND additional people (additional people are: employees, technicians, spouse, etc.)

Additional people ONLY (additional people are: employees, technicians, spouse, etc.)

Including yourself, how many people are you registering?*

How many people are you registering?*

Attendee #1

Name

First Last

Phone

Attendee #2

Name

First Last

Phone

Attendee #3

Name

First Last

Phone

Attendee #4

Name

First Last

Phone

Attendee #5

Name

First Last

Phone

Attendee #6

Name

First Last

Phone

Attendee #7

Name

First Last

Phone

Attendee #8

Name

First Last

Phone

Attendee #9

Name

First Last

Phone

Attendee #10

Name

First Last

Phone

Donation

Would you like to donate to the Florida Committee on Water Quality?*

Yes

Donation Choices

Please pick an a level below. If you would like to set your own donation amount, choose "Custom" and a box will appear.

Custom Donation

Please put an amount below. Must be a number.

Please enter a number greater than or equal to 0.

Total Cost

FWQA Membership

Price:

1 Attendee Member Total

Number of Attendees X $50

Price:

2-5 Attendees Member Total

Number of Attendees X $45

Price: $0.00

6 Or More Attendees Member Total

Number of Attendees X $35

Price: $0.00

1 Attendee New Member Total

Number of Attendees X $50

Price:

2-5 Attendees New Member Total

Number of Attendees X $45

Price: $0.00

6 Or More Attendees New Member Total

Number of Attendees X $35

Price: $0.00

1 Attendee Non Member Total

Number of Attendees X $75

Price:

Attendees for Non-Member

Number of Attendees X $75

Price: $0.00

Donation Amount

Price: $25.00

Total