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| * is a required field. |
| Compliments Of: * |
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| Booth Number: |
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| Expo Date: *Monday
Tuesday |
| *Non Member |
WEF Member ID |
| First Name: * |
Last Name: * |
| Company: * |
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| Address:* |
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| City * |
State
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Zip/Postal Code * |
Country *
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| Phone Number * |
Fax Number |
| E-Mail * |
| Gender: M F |
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| 1. What is the nature of your organization? (ORG) (circle one only)* |
01 Municipal/District Water and Wastewater Systems and/or
Plants |
07 Research or Analytical Laboratories |
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02 Municipal/District Wastewater Only Systems and/or Plants |
08 Educational Institution (Colleges and Universities, Libraries,
and other related organizations) |
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03 Municipal/District Water Only Systems and/or Plants |
09 Manufacturer of Water/Wastewater Equipment or Products |
04 Industrial Systems/Plants (Manufacturing, Processing,
Extraction) |
10 Water/Wastewater Product Distributor or Manufacturer's
Rep. |
05 Consulting or Contracting Firm (e.g., Engineering, Contracting
and Environmental) |
11 Other (please specify) |
06 State, Federal, Regional Government Agency (e.g., U.S. EPA,
State Agency, etc.) |
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| 2. What is your Primary JOB FUNCTION? (JOB) (circle one only)* |
01 Upper or Senior Management (e.g., President, Vice President,
Owner, Director, Executive Director, General Manager etc.) |
06 Purchasing/Marketing/Sales
(e.g., Purchasing, Sales Person, Market Representative,
Market Analyst, etc.) |
02 Engineering, Laboratory and Operations Management
(e.g., Superintendent, Manager, Section Head, Department Head,
Chief Engineer, Division Head, etc.,) |
07 Educator
(e.g., Professor, Teacher, etc.) |
03 Engineering and Design Staff
(e.g., Consulting Engineer, Civil Engineer, Mechanical Engineer,
Chemical Engineer, Planning Engineer, etc.) |
08 Student |
04 Scientific And Research Staff
(e.g., Chemist, Biologist, Analyst, Lab Technician, etc.) |
09 Elected or Appointed Public Official (Mayor, Commissioner,
Board or Council Member, etc.) |
05 Operations
(e.g., Shift Supervisor, Foreman, Plant Operator, Service
Representative, Collection Systems Operator, etc.) |
10 Other (please specify) |
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| 3. What areas do you consider to be your KEY FOCUS AREAS? (FOC) (circle all that apply)* |
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01 Collection Systems |
10 Stormwater |
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02 Drinking Water |
11 Toxic and Hazardous Material |
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03 Industrial Water/Wastewater/Process Water |
12 Utility Management and Environmental |
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04 Groundwater |
13 Wastewater |
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05 Odor/Air Emissions |
14 Water Reuse and/or Recycle |
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06 Land and Soil Systems |
15 Watershed/Surface Water Systems |
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07 Legislation (Policy, Legislation, Regulation) |
16 Water/Wastewater Analysis and Health/Safety Water
Systems |
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08 Public Education/Information |
17 Other (please specify) |
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09 Residuals/Sludge/Biosolids/Solid Waste |
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| 4. How many years have you worked in the industry?* |
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01 1-5 years |
04 21-30 years |
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02 6-10 years |
05 >30 years |
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03 11-20 years |
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| 5. Education/Concentration Area(s) (CON)* |
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01 Physical Sciences (Chemistry, Physics, etc.) |
04 Liberal Arts |
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02 Biological Sciences |
05 Law |
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03 Engineering Sciences |
06 Business |
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| 6. Education level* |
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01 High School |
05 Bachelors Degree |
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02 Technical School |
06 Masters Degree |
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03 Some College |
07 JD |
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04 Associates Degree |
08 PhD |
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| 7. Are you a first time WEFTEC attendee? *Y N |
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