AMTA Workshop RegistrationLowell, MA | October 20-22, 2020 Pushing the Envelope: Research, Innovation and New Directions in DesalinationUMass Lowell Inn & Conference Center | Lowell, MATuesday-Thursday, October 20-22, 2020 RegistrantSalutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast 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*CellEmail*Enter registered attendee's email address Website Special NeedsFood Allergies (describe below)Gluten Free MealsVegan MealsVegetarian MealsWheelchair AccessOther (describe below)Special Needs Comments Member AMTA IDA (check all that apply) Billing Contact InformationEnter billing contact information, if applicableBilling Contact NameEnter billing contact's first and last name, if applicableBilling Contact EmailEnter billing contact's email address, if applicable Billing Contact Phone Please send copy of the invoice/receipt to Billing Contact Staying at Host HotelMake hotel arrangements directly with the UMass Lowell Inn & Conference Center by phone at 978-934-6920. Refer to AMTA for the discounted room rate. Book by October 6th and save!Will you be staying at the Host Hotel?*Staying at the host hotelNot staying at the host hotelHow many nights will you be staying at the Host Hotel?* Workshop RegistrationDiscount rates apply to registrations that are paid in full by Oct. 6th. To Sponsor/Exhibit click option below. To register as an Attendee, click No Sponsorship and No Exhibit and select appropriate Registration option under Workshop Attendee Discount Rates.Workshop RegistrationTo Sponsor/Exhibit click option below. To register as an Attendee, click No Sponsorship and No Exhibit and select appropriate Registration option under Workshop Attendee. Today - Date Date Format: MM slash DD slash YYYY Event Sponsor Details Show Sponsorship Details Bronze: $ 600 - Company Name in Brochure and AMTA Promotional Presentation during Breaks - Recognition as a Break Sponsor Silver: $ 800 - Company Name in Brochure and AMTA Promotional Presentation during Breaks - Recognition as a Breakfast Sponsor Gold Gold-A Package: $1,200 - includes one registration Gold-B Package: $1,650 - includes a Table Top Package - Company Name in Brochure and AMTA Promotional Presentation during Breaks - Recognition as a Lunch Sponsor Platinum Platinum-A Package: $1,400 - includes one registration Platinum-B Package: $1,850 - includes a Table Top Package - Company Logo in Brochure and AMTA Website - Dedicated Slide in the AMTA Promotional Presentation during Breaks - Recognition as a Major Sponsor Optional Tour: $1,000 - includes one registration - Company Name in Brochure and AMTA Promotional Presentation during Breaks - Recognition as an Optional Tour Sponsor Networking Event: $1,500 - $ 6,000 - includes one registration - Company Name in Brochure and AMTA Promotional Presentation during Breaks - Recognition as a Networking Event SponsorEvent Sponsor*Bronze Sponsor, $600Silver Sponsor, $800Gold-A Sponsor, $1,200Gold-B Sponsor, $1,650Platinum-A Sponsor, $1,400Platinum-B Sponsor, $1,850Optional Tour Sponsor, $1,000Networking Event Sponsor ($2,000-$6,000), $0No SponsorshipA Package includes one full attendee registration only B Package includes a Table Top Package, which includes one full attendee registration Spaces are selected onsite - first come, first served. Must be a Div 1 (Utility) or Div 2 (Corporate) member to exhibit.Networking Event Sponsor ($2,000-$6,000)* Package includes one full attendee registration per $2,000Exhibit Space*Table Top Exhibit, $750No ExhibitOne full attendee registration included in Exhibitor Package.Spaces are selected onsite - first come, first served.Must be a Div 1 (Utility) or Div 2 (Corporate) member to exhibit. Select the provided links for more information on types of AMTA MembershipExhibit Space (included with sponsorship package)Table Top ExhibitOne full attendee registration included in Exhibitor Package.Company Description*100-word company descriptionUpload Company Logoplease provide a High Resolution, 300 DPI or greater Drop files here or Accepted file types: jpg, gif, png, pdf, eps, psd. Included Attendee?*I will be the AttendeeSend a Registration Link, another person will be attendingSpeaker/Moderator? Speaker Moderator Workshop Attendee Discount Rates*If not a member, Join AMTA Now for Member Discounted RatesAMTA / IDA Member, $300AMTA / IDA Utility Member, $175Non-Member - Operator, $200Non-Member - All Other Professions, $400Govt. Regulators/Full-Time Students, $75Non-Attendee - Purchase Materials Only, $30Speaker/Moderator Workshop Attendee Discount Rates*If not a member, Join AMTA Now for Member Discounted RatesAMTA Member, $150AMTA Utility Member, $87.50Non-Member - Operator, $100Non-Member - All Other Professions, $200Govt. Regulators/Full-Time Students, $37.50Workshop Attendee*If not a member, Join AMTA Now for Member Discounted RatesAMTA Member, $400AMTA Utility Member, $275Non-Member - Operator, $300Non-Member - All Other Professions, $500Govt. Regulators/Full-Time Students, $100Non-Attendee - Purchase Materials Only, $30Speaker/Moderator Workshop Attendee*If not a member, Join AMTA Now for Member Discounted RatesAMTA Member, $200AMTA Utility Member, $137.50Non-Member - Operator, $150Non-Member - All Other Professions, $250Govt. Regulators/Full-Time Students, $50Student ID RequiredUpload Student ID Workshop ActivitiesOptional Facility Tour*Facility Name Tues., Oct. 20th - 6:00-8:00pmAttending Optional Facility TourNot Attending Optional Facility TourFacility Tour*Wed., Oct. 21st - 1:00-4:00pmAttending Plant FacilityNot Attending Plant TourNetworking Event*Wed., Oct. 21st - 4:30-6:00pmAttending Networking EventNot Attending Networking EventGuest/Spouse Networking Event*Wed., Oct. 21st - 4:30-6:00pmGuest Attending Networking Event, $10Guest Not Attending Networking Fun EventGuest Name*Enter Guest's First and Last Name Need Contact Hours Certification?*Yes, need contact hours certificationNo contact hours requiredIncluded with registration fee.License #*License State*License Type*License Class* Total FeeTotal $0.00 Payment InformationDue to the COVID-19 Pandemic, registration payments will be processed after May 15th. Please select Invoice if you would like to pay by Credit Card. After May 15th, an email will be sent with a link for you to enter your credit card for payment processing.Payment Method*InvoiceCheckMail check made payable to: American Membrane Technology Association 2409 SE Dixie Hwy., Stuart, FL 34996 Cancellations and RefundsWritten cancellation requests received by AMTA on or before October 6, 2020 will receive a refund, less a $50 processing fee. Full payment is required if cancellation is received on or after October 7, 2020 - 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 Comments & CaptchaCommentsCAPTCHA Please refer to AMTA’s Privacy Policy if you have any questions regarding your preferences.