Registration

To register for courses, complete this form, press Register below, and mail it with check enclosed to Vermont Rural Water Assn., 20 Susie Wilson Road, Suite B, Essex Junction, VT 05452-2827.

Course Name:
Number of Attendees:
Attendee Name(s): One per line, please.
System Name:
Certification Type:
Address:
City:
State:	Zip:
Phone:	Emergency Phone:
(Emergency phone is for cancellations due to weather.)
E-Mail:

Are you a Vermont Community or NTNC Water System serving a population of 3,300 or fewer?		Yes No
If yes, please enter your system's Vermont WSID #
Membership Status: Member Non-Member
VRWA Members receive a 20% discount. Click here to become a member.
Comments:

Items in bold are required