Apply or Renew - ORWA System Membership - Oklahoma Rural Water Association

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
System Name/Applicant*
Your Name
First Last
Your Job Title

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Office Phone*
Office Fax
Email Address*
For E-news/Official Correspondence/Legislative Alerts/Training Info
Website URL

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When is your Board Meeting held?*
Examples: Monthly on 1st Monday; Quarterly on 3rd Wednesday
Office Hours
Example: 8AM-5pm Mon-Fri; 8AM-Noon Sat; Closed Sun
Rural Development Funded*
- Yes
- No
System Type(s)*
Select all that apply
- Surface
- Wells
- Purchased
- Sewer

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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

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Annual Dues = $90.00 membership fee + $0.90 per connection (Maximum: $4,000)
Number of Connections*
x $0.90 per connection
per fee
Connections Fee
Price: $0.00
+ $90.00 Base Membership Fee
Maximum Connections Fee
Price: $0.00
+ $90.00 Base Membership Fee
Base Membership Fee
Donation Options (voluntary)
Public Relations Campaign
Suggested donation is $0.90 per connection
ORWEF Scholarship Fund
Gene Whatley Scholarship Fund
Apprenticeship Support
Total Payment Due
$0.00

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SYSTEM OFFICIALS AND PERSONNEL - PLEASE READ
One Advocate will be mailed to the names and home addresses on this application. If there are duplicate addresses only one copy of The Advocate will be mailed. All other correspondence will be emailed. Names and titles only will be listed in the next directory. ORWA is no longer sending training notices through the US Mail.
CHAIRPERSON
CHAIRPERSON Name
First Last
Address
Street Address City State ZIP Code
Phone
Email
VICE-CHAIR
VICE-CHAIR Name
First Last
Address
Street Address City State ZIP Code
Phone
Email
SECRETARY
SECRETARY Name
First Last
Address
Street Address City State ZIP Code
Phone
Email
TREASURER
TREASURER Name
First Last
Address
Street Address City State ZIP Code
Phone
Email

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SYSTEM OFFICIALS AND PERSONNEL (Continued)
SYSTEM MANAGER
SYSTEM MANAGER Name
First Last
Address
Street Address City State ZIP Code
Phone
Email
OFFICE MANAGER
OFFICE MANAGER Name
First Last
Address
Street Address City State ZIP Code
Phone
Email
OPERATOR 1
OPERATOR 1 Name
First Last
Address
Street Address City State ZIP Code
Phone
Email
OPERATOR 2
OPERATOR 2 Name
First Last
Address
Street Address City State ZIP Code
Phone
Email
BOOKKEEPER
BOOKKEEPER Name
First Last
Address
Street Address City State ZIP Code
Phone
Email
ADDITIONAL STAFF
Total
$0.00
Additional Staff
You may list any additional operators or staff here, if needed.

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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 Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
eCheck*
Name on Account Bank Name Routing Number Account NumberAccount Type
Comments
This field is for validation purposes and should be left unchanged.

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Apply or Renew – ORWA System Membership