MOWMA Membership Application

Membership Application

By completing this application, you are applying for membership in the Manitoba Onsite Wastewater Management Association (MOWMA). Membership will provide you with the rights, benefits, and responsibilities associated with that provincial association. Please note that memberships are set to automatically renew annually unless written notice of cancellation is provided prior to the renewal date.
Company Name*
Corporate Membership Name (Account Contact)*

First NameLast Name
Address for Membership Account*

Street Address

Street Address Line 2

CityState / Province

Postal Code
British ColumbiaAlbertaSaskatchewanManitobaOther
Business Phone Number for Membership Account*
Please enter a valid phone number.Format: (000) 000-0000.
Mobile Phone Number for Membership Account
Please enter a valid phone number.Format: (000) 000-0000.
Email for Membership Account*
example@example.com
Business URL For Membership Account
Add your business web address (optional)
Locate-A-Pro Member Profile

The following questions collect information to create your business profile for our Locate-A-Pro directory, which is published on our website. This directory helps connect members of the public and industry stakeholders with qualified professionals. Please complete the fields below as you would like them to appear online.
YesNo
Design/Plan ConsultantsInstallers/ContractorsDesigner-Complex SystemPumpersPermitting AgentsWork Camp ServicesSuppliers-EquipmentSuppliers-ServicesGovernment OrganizationsInspector-ComplianceInspector-PerformanceMaintenance Provider
Select the Municipalities you would like to be listed in on the MOWMA Locate-A-Pro (Max 5)*
*HOLD Ctrl Key to select multiple entries above
Credit CardE-Transfer
$200 CAD
$300 CAD

My Products

1-Year Corporate Membership MOWMA

1-Year MOWMA Corporate Membership

$200.00CAD

1-Year Corporate Membership + Under Corporate Membership Bundle MOWMA

1-Year MOWMA Corporate Membership -- Includes 1 or 2 Under Corporates

$300.00CAD

Total

$0.00CAD

Credit Card

Complete the following fields if you selected a membership bundle that includes Under Corporate Memberships
Under Corporate Member #1

First NameLast Name
Phone Number Under Corporate Member #1
Please enter a valid phone number.Format: (000) 000-0000.
Email Under Corporate Member #1
example@example.com
Under Corporate Member #2

First NameLast Name
Phone Number Under Corporate Member #2
Please enter a valid phone number.Format: (000) 000-0000.
Email Under Corporate Member #2
example@example.com
Type a question*

Powered by Jotform SignClear
Send E-Transfer Payment to: accounting@mowma.org
Should be Empty: