Registration

To register for courses, complete this form, press Register below, and mail it with check enclosed to Vermont Rural Water Assn., 20 Susie Wilson Road, Suite B, Essex Junction, VT 05452-2827. People who register for our classes after the registration deadline must pay a $20 late fee. Registration deadline is two days before course start date.

Course Name:	4/15/10 — Small Systems Class 2 Operator Certification Course
Course Location:	Central Vermont Memorial Civic Center 10 Gallison Hill Road, Montpelier, VT
Number of Attendees:
Attendee Name(s): One per line, please.
System Name:
Certification Type:
Address:
City:
State:		Zip:
Phone:		Emergency Phone:
(Emergency phone is for cancellations due to weather.)
E-Mail:

Please enter your system's Vermont Wastewater or Water Supply ID #
Membership Status: Member Non-Member
VRWA Members receive a 20% discount. Click here to become a member.
Comments:

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Items in bold are required.