Sampling & Monitoring for Small Water Systems – Polson

When:

April 19, 2022 @ 9:00 am – 4:00 pm

2022-04-19T09:00:00-06:00

2022-04-19T16:00:00-06:00

Where:

Polson Rural Fire District
258 Regatta Rd
Polson
MT 59860

Cost:

$60 or $90

Contact:

Julie Allen

406-438-2070

Workshop Date*

Please put the date of the workshop you are registering for.
System/Company Name*
PWS ID #*

This number begins with MT000 and is assigned to your system by MDEQ
Attendee Name*
First Last
Attendee Name
First Last
Use if two people are attending and you're paying for both.
Attendee Name
First Last
Use if three are attending and you're paying for all three.
Title*
Operator #*
Phone*
Email*
Address*
Street Address Address Line 2 City State ZIP Code
Workshop Fee*
Members: $60 per person Non-Members: $90 per person
How Many Attending?*
Workshop Fees are based on a per hour fee of $15 non-members and $10 members.
Donation

Donation to the MT Rural Water Education Fund
Select Your Payment Method*
- Pay Online
- Pay by Phone
- Pay by Check
Convenience Fee (3%)
Price: $0.00
Please note that a 3% convenience fee will be applied for credit card payments.
Total Payment Due
$0.00
To pay by check, submit this form and bring your check to the workshop or mail your payment to:

MRWS
525 Central Ave M6
Great Falls, MT 59401
To pay by phone, submit this form then call MRWS office at 406-454-1151 to pay by credit card over the phone.

Please note that a 3% convenience fee will be applied for credit card payments.
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
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Comments
This field is for validation purposes and should be left unchanged.

Earl Applekamp

April 4, 2022 at 10:10 am

I will need a receipt for reimbursement, will that be mailed or do I get it at class?

Julie Allen
April 4, 2022 at 11:51 am

Hi Earl, The system should have sent you one. Please check your spam folder. It will go to the same email address that you registered with.
Julie