Membership Application

WSC's Member Services:

• Discounts on publications (up to 25%)
• Free subscription to Well Connected®, WSC's quarterly newsletter
• Free Membership Directory and hotlink to your website from WSC's website
• Free listing in PAS-97(04) and ANSI/WSC PST 2000-2005, if qualified (included in dues)
• Access to Members-Only Forum where you will find monthly updates on state legislative issues impacting our industry in Around The States
• Networking possibilities at WSC's spring and fall membership meetings
• Industry leadership opportunities
• Access to WSC information and resources
• First to hear about new industry research
• Representation at the federal level through National Programs Office
• Input on WSC's wellcare® program activities

* = required

Membership Type	ManufacturerDistributorUnafilliatedAllied Interest - Manufacturers RepAllied Interest - AssociationContractor MembersOther
Your First Name	*
Your Last Name	*
Company / Organization	*
Address 1	*
Address 2
City	*
State	AlaskaAlabamaArkansasArizonaBritish Columbia (Canada)CaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsManitoba (Canada)MarylandMaineMichiganMinnesotaMissouriMississippiMontanaNew Brunswick (Canada)North CarolinaNorth DakotaNebraskaNewfoundland (Canada)New HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOntario (Canada)OregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaSaskatchewan (Canada)TennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyomingOther  *
Zip	*
Phone	*
Fax
Email	*
Manufacturer and Distributor Members: Please specify key contact.
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 2012 Dues Payable
$0 - $2,999,999	$3,675.00
$3,000,000 - $4,999,999	$6,259.00
$5,000,000 - $6,999,999	$8,777.00
$7,000,000 - $11,999,999	$15,048.00
$12,000,000 - $19,999,999	$16,995.00
$20,000,000 - $29,999,999	$24,252.00
$30,000,000 - $49,999,999	$30,401.00
$50,000,000 and over	$46,344.00

DISTRIBUTOR DUES	$814.00
MANUFACTURER REP DUES	$547.00
ASSOCIATION DUES	$547.00
CONTRACTOR MEMBER DUES	$110.00
OTHER INDIVIDUAL MEMBER DUES	$110.00

Method of Payment	Check Payable to Water Systems Council Bill Me For Full Amount (Manufacturer & Distributor Members Only) PayPal Bill Me Quarterly (Manufacturer Members Only)  *
ENTER THE LETTERS/NUMBERS YOU SEE INTO THE BOX BELOW: