Associate Registration for Mail or Fax

Georgia Rural Water Association
37th Annual Fall Training Conference
October 24 – 26, 2016
Unicoi State Park & Lodge – Helen, GA
Approved for 12 Continuing Education Points
WWW.GRWA.ORG
AGENDA & LODGING
Georgia Rural Water Association Fall Conference
October 24-26, 2016
Unicoi State Park & Lodge - Helen, GA
Monday October 24, 2016
4:00 PM – 6:00 PM REGISTRATION and EXHIBIT SET-UP
Tuesday, October 25, 2016
8:00 AM – 10:30 AM EXHIBIT HALL & REGISTRATION OPEN
8:00 AM – 9:45 AM CONTINENTAL BREAKFAST IN EXHIBIT HALL
10:30 AM – 11:30 AM TRAINING CLASSES
11:30 AM – 1:00 PM LUNCH SERVED IN THE EXHIBIT HALL OPEN
1:00 PM – 4:30 PM TRAINING CLASSES
4:30 PM – 6:00 PM REFRESHMENTS & DOOR PRIZES IN EXHIBIT HALL
Wednesday October 26, 2016
8:00 AM – 9:45 AM EXHIBIT HALL & REGISTRATION OPEN
8:00 AM – 9:30 AM CONTINENTAL BREAKFAST IN EXHIBIT HALL
9:45 AM EXHIBITS CLOSE & BREAKDOWN
9:45 AM – 12:00 AM TRAINING CLASSES
12:00 – 1:00 LUNCH
1:00 – 3:00 TRAINING CLASSES
3:00 ADJOURN
LODGING
Due to the high demand on hotel rooms, GRWA could only secure a limited amount of rooms with a group rate at each hotel. We
recommend making your hotel reservations ASAP. Hampton Inn Group Rate Expires On September 16th All Others Expire on
September 23rd.
Unicoi Lodge: 706 – 878 – 2201
Red Roof Inn: 800 – 733 – 7663
Riverbend: 877 – 464 – 3536 or 706 – 878 - 2155
Regular Rooms $115 / Cabins $149 - $199 $71.99 – refer to the Block Code: $89.00 - 16 Rooms Reserved Under GRWA
B354GRWA10
Group Rate
100 Rooms & 30 Cabins Reserved Under
GRWA Group Rate: Promo Code: 05440
20 Rooms Reserved Under
GRWA Group Rate
Super 8: 800 – 535 – 1251
Best Western: 800 – 435 – 3642 Holiday Inn Express & Suites: 706 – 878 – 1084
$99 - 20 Rooms Reserved Under GRWA
$109 - 25 Rooms Reserved
$169.00 – 15 Rooms Reserved Under GRWA
Group Rate
Under GRWA Group Rate
Group Rate
Other hotels available in Helen, but did not offer group rates.
Hampton Inn: 706 – 878 – 3310
Use Code: GRW
Helendorf River Inn: 706-878-2271
$139 - $149 Riverview
Country Inn & Suites: 800-456-4000
th
Group Rate Ends September 16
20 Rooms Reserved Under GRWA Group Rate
Associate Non-Exhibitor Registration Form
Georgia Rural Water Association – Fall Conference
October 24 - 26, 2016 Helen, GA – Unicoi State Park & Lodge
12 Continuing Education Points for Water & Wastewater Operators
Registration due by September 23, 2016. After September 23rd late fee is applied.
Registration Available Online WWW.GRWA.ORG
Representing:
_
Address: ________________________________________________________
City:
State:
____
_______ ____
Zip Code:
Phone: ____________________________________ Fax:
Email(s) for Confirmation:
____
List company attendees below and indicate if a certificate for CE Points is needed □
□ Certificate
First Name
Last Name
Email
□ _________________________________ ___________________________________ ________________________________________
□ _________________________________ ___________________________________ ________________________________________
□ _________________________________ ___________________________________ ________________________________________
□ _________________________________ ___________________________________ ________________________________________
Conference Registration For NON Exhibitor
Member First Attendee $325
_________
Add’l Attendees ______ x $185 =
__________
Sponsor / Fellowship (Optional) $100
Non Member $385
________
Non Member Add’l Attendees ____ $285 ______
Late Registration After September 23
rd
Member 1st Attendee $340
__________
Add’l Attendees $195
__________
Non-Member $395
Registration Fee Includes: All Training Sessions, Three Meals & Refreshments
● Tuesday – Breakfast, Lunch & Refreshments in the Exhibit Hall
● Wednesday – Breakfast in Exhibit Hall
Payment Options
Check: Make check payable to GRWA and mail check with registration form to:
Georgia Rural Water Association P.O. Box 383 Barnesville, GA 30204
Credit Card: Fax this form to GRWA Fax 770 – 358 – 4379
For security, we recommend NOT emailing your credit card information.
You can register and pay online through our PayPal account at www.grwa.org
For questions call 770-358-0221 or Email [email protected]
GRWA EIN # 58-1373517
___________
Non Member Add’l Attd _____ x $295=_______
Total Amount Enclosed $______________
Credit Card:
Visa
MasterCard
American Express
GRWA OFFICE USE:
Discover
Date Paid:
Card# :
Expiration Date:
Cardholder Name:
Security Code:
Amount $:
Check #:
Signature:
Conference information, registration and “Be A Presenter Forms” are also available at WWW.GRWA.ORG
Presentation Form
Georgia Rural Water Association
37th Annual Fall Conference
Unicoi State Park & Lodge - Helen, GA - October 24-26, 2016
If you wish to present, please submit this form to both email addresses below by the end of August.
Submit Form to Both: [email protected] & [email protected]
Presentations must not be used for sales pitches or criticism of other products or competitor(s)
Presenters must register for the Conference
Company Name: ___________________________________________________________________________________
Address: ________________________________________________________________________________________
City: _________________________________________ State: ____________
Zip: ______________________________
Phone: _______________________________ Cell # of Presenter(s) : _______________________________________
Presenter(s) Email for Confirmation: __________________________________________________________________
Name of Presenter(s): _____________________________________________________________________________
Water
Indicate which Session(s) you would like to make a presentation in:
Wastewater
Water Distribution
Finance / Management
Presentation Title: __________________________________________________________________________
________________________________________________________________________________________
Presentation Time:
30 minutes
45 minutes
Presentation Description: _____________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
If you are making a PowerPoint Presentation please have your presentation on a Flash / Jump Drive.
GRWA will provide the following: Laptop, Projector, Screen, Laser Pointer and Wireless Microphone. List any
other A/V Equipment needed for your presentation: _______________________________________________
Questions on presenting - Contact Brent Matthews at [email protected]
Other conference related questions call 770-358-0221 or email [email protected]
WWW.GRWA.ORG