Texas Desal 2019 Annual Conference Registration – Austin, TX – Sept. 2019 Desalination Now: Saying Yes to a Reliable and Affordable Water SupplySonesta Bee Cave Hotel, Austin, TXSeptember 4-6, 2019 RegistrantSalutation*Mr.Mrs.Ms.Dr.First Name*Last Name*Job Title*Company*Address*City*State*Zip/Postal Code*Country*USAAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwePhone*CellEmail*Enter registered attendee's email address WebsiteIndustry Type*ConsultantEngineerOther ResearcherPolicymakerRegulatorStudentUniversity/ProfessorWater Developer/FinancierWater PlannerWater UtilityOther, type belowOther Industry Type* Special Needs (if more than one apply, select other and list in special needs comments)Food Allergies (describe below)Gluten Free MealsPaleo MealsVegan MealsVegetarian MealsWheelchair AccessOther (describe below)Special Needs Comments Staying at Host HotelMake your lodging arrangements directly with the Sonesta Bee Cave Austin by clicking the link provided or by phone at 512-483-5900 and ask for the “#0903TEXDES” rate. This group rate has been negotiated for reservations made by August 13, 2019 (subject to availability)Will you be staying at the Host Hotel?*Yes, I will be staying at the host hotelNo, I will not be staying at the host hotelHow many nights will you be staying at the Host Hotel?* Billing Contact InformationEnter billing contact information, if applicableBilling Contact Name First Last Billing Contact EmailEnter billing contact's email address Billing Contact Phone Please send copy of the invoice/receipt to Billing Contact Conference RegistrationEarly Registration applies to registrations received and paid in full by August 13, 2019In order for discounts to be applied indicate if you are a member and if you are a speaker/moderator.Member?*Not sure? If you would like to confirm membership, click here to email custsrv@texasdesal.comTexas Desal MemberNon-MemberSpeaker/Moderator?*No, not a Speaker/Moderator for this conferenceYes, Speaker/Moderator for this conferenceToday - Date Date Format: MM slash DD slash YYYY Early Registration (Member)*Member, $350Student, $250Cannot Attend Conference - Purchase Materials Only, $30Registration (Member)*Member, $450Student, $300Cannot Attend Conference - Purchase Materials Only, $30Onsite Registration (Member)*Member, $550Student, $350Cannot Attend Conference - Purchase Materials Only, $30Early Registration (Member, Speaker)*Speaker, $175Registration (Member, Speaker)*Speaker, $225Early Registration (Non-Member)*Non-Member, $650Student Non-Member, $300Cannot Attend Conference - Purchase Materials Only, $30Registration (Non-Member)*Non-Member, $750Student Non-Member, $350Cannot Attend Conference - Purchase Materials Only, $30Onsite Registration (Non-Member)*Non-Member, $850Student Non-Member, $400Cannot Attend Conference - Purchase Materials Only, $30Early Registration (Non-Member, Speaker)*Speaker Non-Member, $325Registration (Non-Member, Speaker)*Speaker Non-Member, $375 Conference ActivitiesEd Archuleta Scholarship/Brian William Norris Charity Foundation "Texas vs. the World" Wine Reception (Fee required, charities share net proceeds)*Wednesday, September 4th, 4:30-6:00pmYes, Attending/Guest(s) Scholarship/Texas vs. the World Wine ReceptionNo, Not Attending Scholarship/Texas vs. the World Wine Reception# of Ticket(s) ordering*1 Ticket, $752 Tickets, $1503 Tickets, $2254 Tickets, $3005 Tickets, $3756 Tickets, $4507 Tickets, $5258 Tickets, $6009 Tickets, $67510 Tickets, $750Provide all Guest Name(s)*Enter each Guest First and Last Name; if more than one separate by semi-colonInterested in making a donation to the Ed Archuleta Desalter Scholarship Fund?*Click for more informationYes, I am interested in making a donationNo, I am not interested in making a donationDonation Amount*Donation of, $100Donation of, $250Donation of, $500Donation of, $1000Donation of, $2500Other, Enter AmountEnter Amount* How would you like the acknowledgement listed?*Your NameCompany NameNo acknowledgement neededKeynote and Awards Luncheon (Included in registration fee)*Thursday, September 5th, 12:00-1:15pm Yes, Attending LuncheonNo, Not Attending LuncheonVIP Reception (Included in registration fee)*Thursday, September 5th, 5:00-6:30pmYes, Attending VIP ReceptionNo, Not Attending VIP Reception Additional Guest Tickets AvailableGuest/Spouse Keynote and Awards Luncheon (price per guest)*Wednesday, September 4th, 12:00-1:15pmYes, Guest Attending Luncheon, $75No, Guest Not Attending LuncheonHow many will be attending Luncheon?*1 Ticket, $752 Tickets, $1503 Tickets, $2254 Tickets, $3005 Tickets, $3756 Tickets, $4507 Tickets, $5258 Tickets, $6009 Tickets, $67510 Tickets, $750Guest Name(s) that will be attending Luncheon*Enter each Guest First and Last Name; if more than one separate by semi-colonGuest/Spouse VIP Reception (price per guest)*Wednesday, September 4th, 5:00-6:30pmYes, Guest Attending VIP Reception, $50No, Guest Not Attending VIP ReceptionHow many will be attending VIP Reception?*1 Ticket, $502 Tickets, $1003 Tickets, $1504 Tickets, $2005 Tickets, $2506 Tickets, $3007 Tickets, $3508 Tickets, $4009 Tickets, $45010 Tickets, $500Guest Name(s) that will be attending VIP Reception*Enter each Guest First and Last Name; if more than one separate by semi-colon Contact Hours AvailableContact Hours*Yes, need contact hours certificationNo contact hours requiredincluded in registration feeLicense #*License State*License Type*License Grade* Total Registration FeeTotal Registration Fee $0.00 Payment InformationPayment Method*Credit Card - Online PaymenteCheck (Bank Wire w/o processing fee) - Online PaymentCheckInvoiceIf paying by check: Make checks payable to: Texas Desalination Association (TXD) and mail to: 2409 SE Dixie Hwy., Stuart, FL 34996. Comments Comments or Instructions Written cancellation requests received by TXD on or before August 14, 2019 will receive a refund, less a 25% processing fee. Full payment is required if cancellation is received on or after August 15, 2019 - no refunds and no credits for future events will be granted. However, substitutions may be made at any time. Texas Desal reserves the right to make changes in programs and speakers, or to cancel programs when conditions beyond its control prevail. Every effort will be made to contact each enrollee if a program is cancelled. If a program is not held, TXD’s liability is limited to the refund of the program fee only. toward the scheduled event. Final Step of Application ProcessCAPTCHAPlease refer to TXD’s Privacy Policy if you have any questions regarding your preferences.EmailThis field is for validation purposes and should be left unchanged.
