Apply or Renew – ORWA System Membership Quickly & easily share this renewal application! Email 2022 ORWA System Membership Application Step 1 of 7 14% Memberships run January 1, 2022 – December 31, 2022 Annual Dues = $90.00 membership fee + $0.90 per connection (Maximum: $4,000)Application Type* New Membership Renewal Membership Member Type* Rural Water Corporation Rural Water District Town or Public Works Authority County*IMPORTANT: COUNTY NAME YOUR SYSTEM IS LOCATED IN Select...AdairAlfalfaAtokaBeaverBeckhamBlaineBryanCaddoCanadianCarterCherokeeChoctawCimarronClevelandCoalComancheCottonCraigCreekCusterDelawareDeweyEllisGarfieldGarvinGradyGrantGreerHarmonHarperHaskellHughesJacksonJeffersonJohnstonKayKingfisherKiowaLatimerLe FloreLincolnLoganLoveMcClainMcCurtainMcIntoshMajorMarshallMayesMurrayMuskogeeNobleNowataOkfuskeeOklahomaOkmulgeeOsageOttawaPawneePaynePittsburgPontotocPottawatomiePushmatahaRoger MillsRogersSeminoleSequoyahStephensTexasTillmanTulsaWagonerWashingtonWashitaWoodsWoodwardSystem Name/Applicant* Your Name First Last Your Job Title Mailing Address* PO Box / Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Physical Address* Same as above Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Office Phone*Office FaxEmail Address*For E-news/Official Correspondence/Legislative Alerts/Training Info Website URL When is your Board Meeting held?*Examples: Monthly on 1st Monday; Quarterly on 3rd Wednesday Office HoursExample: 8AM-5pm Mon-Fri; 8AM-Noon Sat; Closed SunRural Development Funded* Yes No System Type(s)*Select all that apply Surface Wells Purchased Sewer GPS Coordinates To improve the efficiency of our field staff in locating system offices, please provide the GPS coordinates of your office. To find the coordinates of your office, locate your position on Google Maps, then right click on your location and select "What's here". Latitude Longitude Annual Dues = $90.00 membership fee + $0.90 per connection (Maximum: $4,000)Number of Connections*x $0.90 per connectionper feeConnections Fee Price: $0.00 + $90.00 Base Membership FeeMaximum Connections Fee Price: $0.00 + $90.00 Base Membership FeeBase Membership FeeDonation Options (voluntary)Public Relations CampaignSuggested donation is $0.90 per connection ORWEF Scholarship Fund Gene Whatley Scholarship Fund Apprenticeship Support Total Payment Due $0.00 Review & Submit Your application is ready to submit! You may use the "Previous" button below to go back and review the information you provided on the previous pages to make sure it is accurate. When you are ready to proceed, click "Submit" below.Payment Method Pay Online (Credit Card) Pay Online (eCheck) Pay by Invoice Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name eCheck* Name on Account Bank Name Routing Number Account NumberCheckingSavingsAccount TypeNameThis field is for validation purposes and should be left unchanged.