Membership Application

Membership Level
Public Agencies, Industrial Users and Water Suppliers:
1A - Large (300K+ population served) - membership includes 1 primary member & 3 additional 3C affiliate members, $825
1B - Medium (10K-300K population served) - membership includes 1 primary & 2 additional 3C affiliate members, $625
1C - Small (<10K population served) - membership includes 1 primary member & 1 additional 3C affiliate member, $550
1D - Industrial End User - membership includes 1 primary member & 2 additional 3C affiliate members, $550
1E - Regulatory - membership includes 1 primary member & 2 additional 3C affiliate member, $300

Company/Corporate Membership:
2A - Up to 15 Members - membership includes 1 primary member & 14 additional 3D affiliate members, $2,800
2B - Up to 10 Members - membership includes 1 primary member & 9 additional 3D affiliate members, $2,050
2C - Up to 5 Members - membership includes 1 primary member & 4 additional 3D affiliate members, $1,075
2D - Up to 2 Members - membership includes 1 primary member & 1 additional 3D affiliate member, $455

Associates:
3A - Individuals, $325
3B - Students, $0
3C - Additional Affiliate of Div. I/University &College Professors, $175
3D - Additional Affiliate of Division IIB,IIC, or IID Member, $300
Today - Date

for pre-paid payment allocations
Membership Type*
- 1A - Public Agencies, Industrial Users and Water Suppliers - Large, $825
- 1B - Public Agencies, Industrial Users and Water Suppliers - Medium, $625
- 1C - Public Agencies, Industrial Users and Water Suppliers - Small, $550
- 1D - Industrial End User, $550
- 1E - Regulatory, $300
- 2A - Company/Corporate Membership - Up to 15 Members, $2800
- 2B - Company/Corporate Membership - Up to 10 Members, $2050
- 2C - Company/Corporate Membership - Up to 5 Members, $1075
- 2D - Company/Corporate Membership - Up to 2 Members, $455
- 3A - Individuals, $325
- 3B - Students (Full-Time, must submit ID), $0
- 3C - Additional Affiliate of Division I Member/University/College Professors, $175
- 3D - Additional Affiliate of Division IIB,IIC,orIID Member, $300
Membership Type*
- 1A - Public Agencies, Industrial Users and Water Suppliers - Large, $825
- 1B - Public Agencies, Industrial Users and Water Suppliers - Medium, $625
- 1C - Public Agencies, Industrial Users and Water Suppliers - Small, $550
- 1D - Industrial End User, $550
- 1E - Regulatory, $300
- 2A - Company/Corporate Membership - Up to 15 Members, $2800
- 2B - Company/Corporate Membership - Up to 10 Members, $2050
- 2C - Company/Corporate Membership - Up to 5 Members, $1075
- 2D - Company/Corporate Membership - Up to 2 Members, $455
- 3A - Individuals, $325
- 3B - Students (Full-Time, must submit ID), $0
- 3C - Additional Affiliate of Division I Member/University/College Professors, $175
- 3D - Additional Affiliate of Division IIB,IIC,orIID Member, $300
Primary Member
Salutation*
First Name*
Middle Initial
Last Name*
Suffix
Job Title*
Organization & Address
Organization*
Mailing Address*
City*
State/Province*
ZIP/Postal Code*
Country*
Contact Information
Telephone*
Cell Phone
Email Address*
Website
Newsletter Printed Version Opt-Out (Foreign & Student Members automatically are enrolled in the Opt-Out)
- I prefer to receive the Solutions Newsletter electronically and not a printed and mailed copy.
Communication and Data Sharing Preference
AMTA has been diligent in Data Security and being compliant with US and other Nations regulations in sharing your contact information as well as receiving email communications from AMTA on upcoming events and other resources.
Email Notifications*
- Opt-In: I would like to receive all email messages from AMTA including: Membership, Event Registrations, other announcements and correspondence.
- Opt-Out: I would not like to receive any promotional/event notice email correspondence from AMTA. However, AMTA will still email me regarding Event Registrations/Membership.
Data Sharing*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Member Profile
Interested in Serving on Committee(s):
- Legislative / Regulatory Programs
- Membership
- Publications / Newsletter
- Technology Transfer
- Young Professionals
- Young Professional Members
- Young Professional Affiliate Members
- Other
Interested in the following:
- Running for position on AMTA Board
- Presenting at a Workshop or Conference
Member Bio
Company Profile
Company Profile
Instructions: if you are applying for a Division 1 or 2 Membership, please check all the categories that apply to your company and what you offer so that when a search is done for those products or services, your company will be listed.
1. Membrane Element / Module Component Manufacturer
- Membrane Element / Module Component Manufacturers
Check all the apply
- Electrodialysis, ED & Electrodialysis Reversal, EDR
- Forward Osmosis, FO
- Membrane Bioreactor, MBR
- Microfiltration, MF
- Reverse Osmosis, RO / Nanofiltration, NF
- Ultrafiltration, UF
2. Membrane System Manufacturer / Supplier
- Membrane System Component Supplier
3. Membrane System Component Supplier
- Membrane System Component Supplier
Check all that apply
- Pumps
- Pressure Vessels
- Instrumentation / SCADA
- Valves & Fittings
- Controls
- Energy Recovery
- Other
4. Membrane System Architect / Engineer / Consultant
- Membrane System Architect / Engineer / Consultant
5. Membrane System Process Integrator
- Membrane System Process Integrator
6. Membrane System Chemical Supplier
- Membrane System Chemical Supplier
7. Membrane System Troubleshooting / Laboratory Support
- Membrane System Troubleshooting / Laboratory Support
8. Membrane System Manager / System Operator
- Membrane System Manager / System Operator
Choose one
- Municipal Water / Wastewater
- Industrial Application - Oil & Gas, Food/Beverage, Other
Check all that apply
- Electrodialysis, ED & Electrodialysis Reversal, EDR
- Forward Osmosis, FO
- Membrane Bioreactor, MBR
- Microfiltration, MF
- Reverse Osmosis, RO/ Nanofiltration, NF
- Ultrafiltration, UF
9. Membrane System Research Center / University
- Membrane System Research Center / University
Please provide proof of your full time student status
Please provide proof that you are a full time student. This proof must be a letter from the Registrar’s office of your University and must reflect the time that you are expected to remain as a full time student. Once you have provided this proof, I can then process your membership.
Submit proof of student full time status
Accepted file types: pdf, doc, docx.
Total Registration Fee
Total
$0.00
Affiliate Member 1
Salutation - Affiliate 1
First Name - Affiliate 1
Middle Initial - Affiliate 1
Last Name - Affiliate 1
Job Title - Affiliate 1
Email Address - Affiliate 1
Member Bio - Affiliate 1
Data Sharing - Affiliate 1*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 2
Salutation - Affiliate 2
First Name - Affiliate 2
Middle Initial - Affiliate 2
Last Name - Affiliate 2
Job Title - Affiliate 2
Email Address - Affiliate 2
Member Bio - Affiliate 2
Data Sharing - Affiliate 2*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 3
Salutation - Affiliate 3
First Name - Affiliate 3
Middle Initial - Affiliate 3
Last Name - Affiliate 3
Job Title - Affiliate 3
Email Address - Affiliate 3
Member Bio - Affiliate 3
Data Sharing - Affiliate 3*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 4
Salutation - Affiliate 4
First Name - Affiliate 4
Middle Initial - Affiliate 4
Last Name - Affiliate 4
Job Title - Affiliate 4
Email Address - Affiliate 4
Member Bio - Affiliate 4
Data Sharing - Affiliate 4*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 5
Salutation - Affiliate 5
First Name - Affiliate 5
Middle Initial - Affiliate 5
Last Name - Affiliate 5
Job Title - Affiliate 5
Email Address - Affiliate 5
Member Bio - Affiliate 5
Data Sharing - Affiliate 5*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 6
Salutation - Affiliate 6
First Name - Affiliate 6
Middle Initial - Affiliate 6
Last Name - Affiliate 6
Job Title - Affiliate 6
Email Address - Affiliate 6
Member Bio - Affiliate 6
Data Sharing - Affiliate 6*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 7
Salutation - Affiliate 7
First Name - Affiliate 7
Middle Initial - Affiliate 7
Last Name - Affiliate 7
Job Title - Affiliate 7
Email Address - Affiliate 7
Member Bio - Affiliate 7
Data Sharing - Affiliate 7*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 8
Salutation - Affiliate 8
First Name - Affiliate 8
Middle Initial - Affiliate 8
Last Name - Affiliate 8
Job Title - Affiliate 8
Email Address - Affiliate 8
Member Bio - Affiliate 8
Data Sharing - Affiliate 8*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 9
Salutation - Affiliate 9
First Name - Affiliate 9
Middle Initial - Affiliate 9
Last Name - Affiliate 9
Job Title - Affiliate 9
Email Address - Affiliate 9
Member Bio - Affiliate 9
Data Sharing - Affiliate 9*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 10
Salutation - Affiliate 10
First Name - Affiliate 10
Middle Initial - Affiliate 10
Last Name - Affiliate 10
Job Title - Affiliate 10
Email Address - Affiliate 10
Member Bio - Affiliate 10
Data Sharing - Affiliate 10*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 11
Salutation - Affiliate 11
First Name - Affiliate 11
Middle Initial - Affiliate 11
Last Name - Affiliate 11
Job Title - Affiliate 11
Email Address - Affiliate 11
Member Bio - Affiliate 11
Data Sharing - Affiliate 11*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 12
Salutation - Affiliate 12
First Name - Affiliate 12
Middle Initial - Affiliate 12
Last Name - Affiliate 12
Job Title - Affiliate 12
Email Address - Affiliate 12
Member Bio - Affiliate 12
Data Sharing - Affiliate 12*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 13
Salutation - Affiliate 13
First Name - Affiliate 13
Middle Initial - Affiliate 13
Last Name - Affiliate 13
Job Title - Affiliate 13
Email Address - Affiliate 13
Member Bio - Affiliate 13
Data Sharing - Affiliate 13*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Affiliate Member 14
Salutation - Affiliate 14
First Name - Affiliate 14
Middle Initial - Affiliate 14
Last Name - Affiliate 14
Job Title - Affiliate 14
Email Address - Affiliate 14
Member Bio - Affiliate 14
Data Sharing - Affiliate 14*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.
Payment Information
Payment Method*
- Credit Card - Online Payment
- eCheck (Bank Wire w/o processing fee) - Online Payment
- Check
- Invoice
If paying by Check, make payable to American Membrane Technology Association, and mail to 2409 SE Dixie Hwy., Stuart, FL 34996.
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Membership Level

Primary Member

Organization & Address

Contact Information

Communication and Data Sharing Preference

Member Profile

Company Profile

Please provide proof of your full time student status

Total Registration Fee

Affiliate Member 1

Affiliate Member 2

Affiliate Member 3

Affiliate Member 4

Affiliate Member 5

Affiliate Member 6

Affiliate Member 7

Affiliate Member 8

Affiliate Member 9

Affiliate Member 10

Affiliate Member 11

Affiliate Member 12

Affiliate Member 13

Affiliate Member 14

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