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1. What is the nature of your organization? (Check ONE only)

Select One Only Water and Wastewater Systems and/or Plants Water Only Systems and/or Plants Wastewater Only Systems and/or Plants Consulting Firms (incl. Engineering, Contracting & Environmental) Industrial Water/Wastewater Facilities or Water Wholesalers Government Agencies/Development Banks/Relief Agencies Educational Institutions Research or Analytical Laboratories Manufacturers or Distributors of Equipment & Supplies (incl. Reps) Others allied to the field (Please specify):

(Please specify): 

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2. If your organization is a water or wastewater system/plant, what is your location/facility? (Check ONE only)

Select One Only Municipally Owned & Operated Investor Owned & Operated Municipally Owned/Investor Operated Other None/Not Applicable

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3.	What is your JOB TITLE? (Check ONE only)

	Executive/Administrative Management(i.e., President, Vice President, Board Member, Mayor, Owner, etc.)
	Engineering & Operations Management (i.e., Division Head, General Manager, Superintendent, Section Head, Department Head, Chief Engineer, etc.)
	Engineering & Design Staff (i.e., Consulting Engineer, Civil Engineer, Mechanical Engineer, Environmental Engineer, Electrical Engineer, Planning Engineer, System Designer, etc.)
	Scientific & Research (i.e., Chemist, Biologist, Biophysicist, Analyst, Lab Technician, etc.)
	Operations (i.e., Foreman, Plant Operator, Maintenance Crewman, Service Representative, Collection Systems, etc.)
	Purchasing/Marketing/Sales (i.e., Purchasing, Market Representative, Salesperson, Sales Representative, Market Analyst, etc.)
	Other (Please specify):

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4.	If your organization is a water or wastewater system/plant, what is the population served by your water system? (Check ONE only)

Select One Only 500 or less 501 - 3,300 3,301 - 10,000 10,001 - 100,000 Greater than 100,000 None/not applicable

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5.	Please check below all PRODUCTS or SYSTEMS that you RECOMMEND, SPECIFY, PURCHASE or APPROVE PURCHASE. (Check ALL that apply)

Aeration Chemicals/Biochemicals Corrosion Control Detectors, Monitors, Recorders Engineering & Construction Services Flow, Pressure & Level Measuring Equipment & Accessories Groundwater Treatment Membranes Desalination/Brackish Water Odor Control Process Control Equipment Safety Equipment SCADA (Supervisory Control & Data Acquisition) Tanks & Structures Water Treatment Equipment

Security Equipment, Systems Computers/Software Customer Information Systems Disinfection Equipment Filtration Equipment Laboratory Equipment, Supplies & Services Meters & Meter Reading Equipment Pipes, Fitting & Related Products Pumps Sampling & Analyzing Equipment & Instrumentation Sludge Dewatering & Processing Equipment Stormwater Equipment & Services Trenchless Equipment & Technology Valves, Seals, Packing & Related Products Wastewater Treatment Equipment Water Well Drilling, Maintenance & Monitoring None of the above

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6.	Please indicate the number of employees at your company.

SELECT ONE ONLY 1 - 19 20 - 49 50 - 99 100 - 249 250 - 499 500 - 999 1,000+ Unknown

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7.	Would you like to receive information on urban water management supplements or conferences?

Yes

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8.	Send me the following newsletters.

Yes   Water & Wastewater Report
Yes   Pump Systems & Innovations
Yes   Water Security & Instrumentation
Yes   Urban Water Management
Yes   Water Utility Management
Yes   International Water Industry Report
Yes   Industrial Water Industry Report
Yes   WaterWorld Continuing Education
Yes   WaterWorld Video News Update

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