Alabama Water and Pollution Control Association
ALABAMA WATER POLLUTION CONTROL ASSOCIATION
INDIVIDUAL MEMBERSHIP APPLICATION
INDIVIDUAL INFORMATION:
Name:____________________________
Home Mailing Address(required):___________________________________
City:________________ County:___________________ state:_____ Zip:_______
Home Phone #:_______________________
Work Phone#:______________________
Email Address (required):___________________________
Job Title:__________________________
PLEASE CIRCLE YOUR CERTIFICATION GRADE:
WATER: I II III IV WASTEWATER: I II III IV
EMPLOYER INFORMATION:
Employer:___________________________________________________________
Employer Address:____________________________________________________
Facility Name:_______________________________________________________
City:________________ County:___________________ state:_____ Zip:_______
METHOD OF PAYMENT:
Enclosed is: Check_____ Money Order_____ Cash_____ in the amount of $40.00
(Please make checks or money orders payable to AWPCA)
Signature of Applicant:_________________________________________________
AWPCA MEMBERSHIP:
Be sure to fill in your home mailing address. Be sure to do this for each person you are paying dues for. This will insure you receive all special mailings and fliers that are sent out periodically. You can print out this page, fill it out and return the completed membership application along with your check/money order made payable to "AWPCA" to:
AWPCA Membership
P. O. Box 180176
Mobile, AL 36618-0176
MEMBERSHIP DUES - are due on or before January 1st each year. Unpaid dues are in arrears February 15th of each year.
Notice: Online renewals are now being processed through the link below.
IMPORTANT NOTICE: If you pay with a credit card you MUST complete the process all the way through Paypal. You can pay with credit card on Paypal as a guest. you do not have to have a Paypal account but payments are processed through them.
Paypal Customer Service: 1(888)221-1161 for any issues regarding payment processing.
Online Renewal Forms:
Single Membership - New Membership or Renewal
Multi-Member New Membership/Renewals