NAME: (only one name per form) AWWA MEMBER #:

TITLE: ORGANIZATION:

ADDRESS:

CITY / STATE / ZIP:

OFFICE TELEPHONE: ( ) FAX: ( )

EMAIL:

Last First Initial

REGISTRATION FEESEmployees of Companies holding a Utility membership qualify for the Member rates.

Full conference - member* c Advance: $125 c On-site: $185Full conference - non-member* c Advance: $215 c On-site: $265One day - member* c Advance: $100 c On-site: $135 Day:One day - non-member* c Advance: $195 c On-site: $230 Day:

*A $10.00 fee will be charged for all on-site name changes on pre-registration name badges.COMPLIMENTARY REGISTRATIONSc Student, full-time c Retired (AWWA members only)c Guest (Admittance to receptions only) Name:_________________________________.EARLY BIRD REGISTRATIONMonday, Jan. 21, 3:00 - 7:00 p.m. MEALS ~ Tickets requiredc Tuesday, Jan. 22, 12-noon: Keynote luncheon - $30c Wednesday, Jan. 23, 12-noon: Awards luncheon - $30c Thursday, Jan. 24, 7:30 a.m.: Breakfast - $20

Total Amount Enclosed: $ Return this completed form with payment to the address below or visit www.inawwa.org to register online.

o Check made payable to Indiana Section AWWA is enclosed. (Check no.: )

o Pay via credit card: A secure link will be sent to email above.

The DEADLINE for ADVANCE registration is Jan. 11, 2019

111th Annual Meeting

INDIANA SECTION AWWAMarriott Hotel - Indianapolis, IN

January 21-24, 2019

R E G I S T R A T I O N F O R MU T I L I T Y / O P E R A T O R / G O V E R N M E N T

RETURN COMPLETED FORM TO:

Indiana Section AWWA2680 E. Main St., #106

Plainfield, IN 46168Office: (866) 213-2796FAX: (866) 215-5966

ONLY ONE NAME PERFORM, PLEASE!

Photocopy the registration form for use by others or go to

our web site for additional forms or to register online.

www.inawwa.org

REFUND POLICYYou can recover your

pre-payment by written request,postmarked no later than

Jan. 1, 2019, to Dawn Keyler.Request for refunds made afterthat date cannot be honored.

SPECIAL NEEDSEvery reasonable effort will bemade to accommodate special

needs. Please contact Dawn Keyler at (866) 213-2796

or dawn.keyler@inawwa.orgwith your request.

105th Annual Meeting

INDIANASECTION

AWWAMarriott Hotel - Indianapolis, IN

February 12-14, 2013

with special guest

Howard Kellmankeynote speaker

Indiana Section AWWA8365 Keystone CrossingSuite 300Indianapolis, IN 46240

PRSRT. FIRST CLASSUS POSTAGE

P A I DIndianapolis, INPermit No. 5677

Indiana Section AWWA2680 E. Main StreetSuite 106Plainfield, IN 46168

HOTEL ACCOMMODATIONSMARRIOTT HOTEL

350 W. MARYLAND ST., INDIANAPOLIS(800) 266-9432

For on-line room reservations go to https://book.passkey.com/go/awwajan2019Hotel reservations are your responsibility. For your convenience, the Indiana Section AWWA has reserved a block of rooms for the conference at the rate of $145 / day plus applicable state and local taxes. Rooms will be released to the general public on January 11, 2019. However,rooms may be sold out prior to this date. We strongly encourage you to make room reservations as early as possible to avoid being placed off-site.

R E G I S T E R T O D A Y !CEU’S - Awaiting IDEM contact hour approval on water and wastewater sessions, and also exhibit hall presentations. We anticipate amaximum of 13.5 technical water hours, and 13.5 technical & general waster hours.PRE-REGISTRATION - Take advantage of the discount! It will save you time at the registration desk and will help us plan more accuratelyfor conference events. The deadline for pre-registration is Jan. 11th, 2019.REGISTRATION BADGE - Your registration badge is required for admittance to all functions, including the social events.MONDAY Early Bird Registration 3:00 p.m. - 7:00 p.m.TUESDAY EVENING – FULLER AWARD RECEPTION & WATER-FOR-PEOPLE SILENT AUCTION - To honor the Fuller Awardrecipient, a festive reception and celebration is planned for Tuesday evening, immediately following the sessions.WEDNESDAY EVENING – COMPETITION RECEPTION - A festive competition of Meter Madness district winners, including lastyear’s Section winner, on who can assemble a meter the fastest. Also during our reception will be the finals of our Hydrant Hysteriacompetion, where teams compete to assemble a fire hydrant. The winners of both competitions will go to compete against Section winners from across the country, with travel and lodging expenses to ACE19 in Denver, CO. for the Section winner to be covered bythe Indiana Section AWWA.SPOUSE/GUEST REGISTRATION - Spouse or guest must be registered. Please indicate this on the form on opposite side. (Admittance toreceptions only.)

**You can register online at www.inawwa.org or visit the website to print additinal registration forms**

UTILITIES