AMTA Online Training Sponsorship 2021 Technology Training Online SponsorPlease refrain from using all caps/uppercase letters, please use sentence structure letter case.Salutation*Mr.Mrs.Ms.Dr.First Name* Middle Initial Last Name* Job Title* Company* Address* City* State*Not Applicable, InternationalAKAZARCACOCTDCDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYZip* Country*AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUSAUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwePhone* Cell Email* Individual Social Media UsernamesLinkedIn Twitter Website Company/Organization Social Media UsernamesLinkedIn Twitter HiddenMember AMTA NWMOA SEDA SCMA SWMOA IDA (check all that apply) Billing Contact InformationEnter billing contact information, if applicableBilling Contact Name Billing Contact EmailEnter billing contact's email address, if applicable Billing Contact Phone Please send copy of the invoice/receipt to Billing Contact Sponsor Opportunities Online Training Sponsor: $250 Branding on the AMTA Online Education & Training Webpage Branding and sponsor recognition on opening slide in the opening and closing slide at the end of the webinar. Thank-you recognition in upcoming Solutions Newsletter Branding on all marketing eblasts and social media for specific webinar series (does not include AMTA/AWWA membrane master class series) Registrant list for each webinar series and a 25% discount on staff registration HiddenToday - Date MM slash DD slash YYYY HiddenSponsorship Online Training Sponsorship Series, $250 Sponsorship Online Training Series Ceramic Membranes, $250 Membrane Cleaning, $250 Will you be Attending?* I will be an Attendee Not Attending Company Logo and DescriptionCheck box(s) to upload/update logo or description Company Logo Company Description Upload Company Logo*please provide a High Resolution, 300 DPI or greater Drop files here or Select files Max. file size: 100 MB. Company Description*100-word company description Online Training PolicyOnline Training Policy* Online Training Technical Requirements AMTA provides each attendee with the link to access the online training along with instructions. Participants are responsible for ensuring that: they have the needed equipment; it is functioning; it is compatible with the online training system; and they know how to use it. AMTA is not responsible for technical support before, during or after the online training. For technical support, please visit https://support.goto.com/webinar. AMTA’s refund policy excludes attendees experiencing technical difficulties or equipment failures. AMTA online trainings are conducted using GoToWebinar. It is highly recommended that you use the link provided to the GoToWebinar website to view compatibility requirements prior to the scheduled training. You must have access to a computer with an internet connection and an audio connection (phone line or computer mic and speaker). It is recommended that you participate from a quiet location where there will be few distractions. Online Training Continuing Education Units Requirements Inability to complete CEU requirements will result in no CEU’s being issued, regardless of the reason. • Attendees must pre‐register and provide a valid certification number. • Each attendee must be logged into a separate computer so that their participation may be accurately tracked. • Attendees must be logged in at the beginning and must remain logged in through the end of the session. • Attendees must promptly respond to brief quizzes or polling questions that appear randomly throughout the online training. • No partial credit will be given. • After the online training, AMTA staff will email CEU documentation to attendees meeting the CEU requirements. Reports will also be sent to the appropriate certification agencies. Online Training Recordings Online training participants should be aware that the online training they attend will be recorded. AMTA holds a perpetual license to copy, distribute, make videos, DVDs, CDs, publish, reproduce the recording, to post the recording on its website, to sell the recording or any copy or derivative thereof, to market and publicize the recording, all without any fee or compensation paid or to be paid to participants by AMTA. Prohibition of Recording: Recording of any sounds or visual images and use of any recording device now known, or later developed, is prohibited unless prior written permission has been expressly granted by AMTA. I agree to the Online Training Policy* Personal / Preferred Email Address to send Virtual Access Link If providing an alternate email other than listed above for receiving virtual access, provide the email address here. Need Contact Hours/CEUs? Need Contact Hours/CEUs? License # License State License Type License Class Total FeeTotal $0.00 Payment InformationPayment Method* Credit Card - Online Payment eCheck (Bank Wire w/o processing fee) - Online Payment Check Invoice Mail check made payable to: American Membrane Technology Association 1811 Englewood Rd., #280, Englewood, FL 34223 Comments & CaptchaCommentsCAPTCHA HiddenCancellations and RefundsWritten cancellation requests received by AMTA 14 days before the event will receive a refund, less a $50 processing fee. Full payment is required if cancellation is received 15 day before the event, no refunds and no credits for future events will be granted. However, substitutions may be made at any time. AMTA reserves the right to make changes in programs and speakers, or to cancel programs when conditions beyond its control prevail. Every effort will be made to contact each enrollee if a program is cancelled. If a program is not held, AMTA’s liability is limited to the refund of the program fee only. 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