REGISTRATION FORM - PAGE 1


March 30 - April 2, 2009

Newport Beach Marriott
900 Newport Center Drive
Newport Beach, CA

Do not use all caps.
Bold letters indicate required fields.
Please complete a separate registration form for each person.
This form may be reproduced without the written permission of Forester Media Inc.

1. Registrant Information:

First Name:

Last Name:

Company/Agency/Affiliation:

Address:

City:

State/Province:

Zip/Postal Code:

Country:

Phone:

Format: 000-123-4567

Fax:

Format: 000-123-4567

E-mail:

Web Site Address:


2. Registration Type (Please Select One):

Attendee Exhibitor Speaker Sponsor

3. Primary Business (Check only one):

Water Utility/Water District/Water Purveyor/Public Works/Irrigation District
Consulting/Engineering/Architectural/Design
Landscape/Irrigation/Contractor/Construction/Developer/Pipeline/Drilling
Municipal/City/County/Other Local Government
State/Federal/Other Government
Dealer/Distributor/Manufacturer/Representative
Other

4. What is your job title?

Owner/President/Vice President/Elected Official
Manager/Director/Foreman/Supervisor/Inspector
Director/Chief/Superintendent
Engineer/Technician/Specialist/Designer
Program Manager/Coordinator/Project Manager/Planner
Plumber
Other (Specify)

5. Do you know of anyone else who might be interested in attending?

Name:

Company/Agency/Affiliation:

Phone:

 Format: 000-123-4567

E-mail:

6. Free Subscription Offer:   Yes! I want to receive Water Efficiency magazine FREE No
What format would you like to receive your Magazine?
Print (Free for US & Canadian readers only)
Digital version (e-mailed with a link - Free to qualified readers worldwide)
Both Print & Digital (e-mailed with a link - Free to US and Canadian readers only)
In order to verify your on-line subscription request, we are required to ask a personal identifying question. This information is used SOLELY for the purpose of auditing your request.
What high school did you attend?
 

7. Sign-up for our Email newsletter. Keep up to date with the latest industry news, events, and trends
 

For problems or questions, please call (805) 682-1300, x 136. We cannot accept international credit card payments online. To pay for your registration using an International credit card, please call the number listed above, or e-mail abridgers@forester.net.