RETURN COMPLETED FORM TO:

Indiana Section AWWA2680 East Main Street, #106

Plainfield, IN 46168Office: (866) 213-2796F

dawn.keyler@inawwa.orgAX: (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.

www.inawwa.org

REFUND POLICYYou can recover your pre-pay-ment by written request, post-marked no later than Jan. 8,

2018, 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.

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

TITLE: ORGANIZATION:

ADDRESS:

CITY / STATE / ZIP:

OFFICE TELEPHONE: ( ) FAX: ( )EMAIL:

Last First Initial

REGISTRATION FEESFull conference - member* Advance: $125 On-site: $185Full conference - non-member* Advance: $215 On-site: $265

One day - member* Advance: $100 On-site: $135 Day:One day - non-member* Advance: $195 On-site: $230 Day:

*A $10.00 fee will be charged for all on-site name changes on pre-registration name badges. (Service Providers Only)

COMPLIMENTARY REGISTRATIONS

Student, full-time Retired (AWWA members only)Guest (Admittance to receptions only) Name:_________________________________.Firs t time attendee / Haven’t Attended in At Least 5 Years (UTILITY REGISTRANTS ONLY)

EARLY BIRD REGISTRATION

Tuesday, January 12, 3:00 - 7:00 p.m.

MEALS ~ Tickets required

Tuesday, January 23, 12-noon: Keynote luncheon - $30 Wednesday, January 24, 12-noon: Awards luncheon - $30 Thursday, January 25, 7:30 a.m.: Breakfast - $20

Total Amount Enclosed: $ Return this completed form with payment to the address below.

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

Pay via Credit Card: A secure link will be sent to the email listed above.

The DEADLINE for ADVANCE registration is January 12, 2018

Marriott Hotel - Indianapolis, INJanuary 22-25, 2018

R E G I S T R A T I O N F O R MA L L A T T E N D E E S

Utility

Service Provider

INDIANA SECTION AWWA110th Annual Conference

HOTEL ACCOMMODATIONSMARRIOTT HOTEL

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

For on-line room reservations go to https://aws.passkey.com/go/INAWWA2018Hotel reservations are your responsibility. For your convenience, the Indiana Section AWWA has reserved a block of rooms for the

conference at the rate of $139 / day plus applicable state and local taxes. Rooms will be released to the general public on January 5, 2018. 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 !

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

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

CEUS ~ Awaiting IDEM contact hour approval on water and wastewater sessions, and also exhibit hall presentations. We anticipate amaximum of 13.5 technical water hours.PRE -REGISTRATION ~ Take advantage of the discount! It will save you time at the registration desk and will help us plan more accurately for conference events. The deadline for pre-registration is January 12, 2018.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 ~ Featuring Meter Madness a festive competition of district winners, includinglast year’s Section winner, on who can assemble a meter the fastest. Also during our reception will be the finals of our new HydrantHysteria Competition, which is similar to Meter Madness, but on a bigger scale, where teams compete to assemble a fire hydrant. The winners of the competitions will go to ACE18 in Las Vegas to compete against Section winners from across the country, with travel and lodging expenses to ACE18 for the Section winner to be covered by the Indiana Section.SPOUSE /GUEST REGISTRATION ~ Spouse or guest must be registered. Please indicate this on the form on opposite side.(Admittance to receptions only.)

Additional Registration Forms can be printed by going to www.inawwa.org