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Membership Application

1) General Information

* = required

Manufacturer and Distributor Members: Please specify key contact.
Membership Type
Your First Name	*
Your Last Name	*
Company / Organization	*
Address 1	*
Address 2
City	*
State	*
Zip	*
Phone	*
Fax
Email	*
Contact First Name
Contact Last Name
Contact Title
Contact Phone
Contact Fax
Contact Email

2) Dues & Payment

**MANUFACTURER DUES STRUCTURE**
Annual Sales Volume in Water Systems Industry	Total 2007 Dues Payable
$0—$2,999,999	$3,280.00
$3,000,000—$4,999,999	$5,587.00
$5,000,000—$6,999,999	$7,834.00
$7,000,000—$11,999,999	$13,432.00
$12,000,000—$19,999,999	$15,170.00
$20,000,000—$29,999,999	$21,646.00
$30,000,000—$49,999,999	$27,135.00
$50,000,000 and over	$41,365.00

DISTRIBUTOR DUES	$727.00
ALLIED INTEREST ORGANIZATION DUES	$500.00
INDIVIDUAL MEMBER DUES	$100.00

Method of Payment	*

Water Systems Council National Programs Office
1101 30th Street, N.W., Suite 500, Washington, DC 20007
Phone: (202) 625-4387 | Fax: (202) 625-4363
Email: wsc@watersystemscouncil.org

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