Annual Conference
Online Registration Form

DAYS ATTENDING

Member

 Member

after February 25

 Non-Member

Non-Member after February 25

 Full Conference (all meals)

$395

$420

$420

$445

Monday (evening Meal)

$100

$125

$125

$150

 Tuesday (lunch & evening meal/

$175

$200

$200

$225

 Wednesday (breakfast & lunch)

$125

$150

$150

$175

 Extra Meal Tickets

 Guest Tickets

Cost

 Total

 Your

Meals

 Mon evening

 $25

 Tues lunch

$15

 Tues Banquet

 $30

Wed Lunch

 $15

Nebraska Rural Water Association
Annual Conference Pre-Registration
March 14 - 16, 2022
Younes Conference Center
Kearney, Nebraska
Pre-Registration
Deadline is March 7th.
THERE IS A $25 LATE FEE
AFTER February 25th
I am the Voting Delegate
Water System/Company Name
Billing Address
Certificate Address
Name (1 person per form)
City, State, Zip
Attendee's email
(Certificates will be emailed if an email address is provided)
License numbers MUST be on this form
WO No.
BF No.
WW No.
WD No.
WO Grade
REGISTRATION INCLUDES TRAINING MATERIALS, MEALS AND BREAKS
No Registrations after March 7th.  Registration fees on-site will increase by $50.

IF YOU REPLACE AN ALREADY REGISTERED PERSON AFTER MARCH 2ND, THERE WILL BE AN EXTRA $25 CHARGE

CANCELLATIONS AFTER MARCH 8TH AND NO SHOWS THE DAY OF THE CONFERENCEWILL BE CHARGED A $25 FEE TO COVER MATERIALS THAT WERE PREPARED BEFORE THE CONFERENCE

FORM MUST BE COMPLETED IN FULLOR YOU WILL NOT BE REGISTERED
The entire conferenceis free for all water system board members.  I am a Board Member (no charge)
Name of Guest
When making room reservations, mention you are with NeRWA

All meals are included for each registration.  Please indicate if you will be staying for the meals.  You will not be charged for them if you are registered - it is for a more accurate count.  The breakfast on Wednesday is complimentary for all registered for the conference.



To Register:
  Online:  www.nerwa.org
    (if you register online, DO NOT mail one.
  Fax:  (402) 443-5274
  Mail:  Nebraska Rural Water Association
3390 Ponderosa Street
Wahoo, NE 68066
                   NO PHONE REGISTRATIONS


Registration  $
Tickets         
$                       TOTAL $

                  NeRWA member:  Bill           Paid online
 
Non-members - Payment must be online or pay when
                                        checking in.

CERTIFICATES WILL NOT BE ISSUED AND HOURS WILL
     NOT BE SUBMITTED TO STATE AGENCIES UNTIL
                            PAYMENT IS RECEIVED.