Municipal Waste Water Virtual Summit 2020 Application

Please complete the below form to apply for the Summit. Make sure to complete the entire form and then click the blue "Continue" button. Please feel free to call Katie Sieracki at 847-773-0147 with any questions. We look forward to reviewing your application!

Event: Municipal Waste Water Virtual Summit 2020
First Name*
Last Name*
Your Title*
First Name on Badge if different from above
Confirm E-Mail*
Work Address*
State (two-letter abbreviation)*
Work Phone Number*
Cell Number*
Emergency Contact Person AND Phone Number*
To verify that you're a real human and not an automated spambot, please answer the following question:
Independence Day is the Fourth of*
*These fields are required to have a value.

Please tell us about your organization:

What is the size of the population your treatment plant services?

How many treatment plants do you manage?

Tell us a little about your organization (2-5 sentences).

Tell us a little about yourself - your background, years in the industry and current scope of responsibility. Are you a sports fan, pet owner, or world traveler? Tell us that, too! (2-5 sentences.)

Does your system handle collection and/or treatment of wastewater?

Please describe your sewer infratructure (number of pumping stations, number of stormwater basins, miles of sewers).

How many gallons of water does your treatment plant(s) process daily (MGD)?

What is currently going well at your organization?

What keeps you up at night regarding your organization?

What other municipal wastewater directors or departments would you recommend we invite to the Summit?

If you could join two roundtable discussions with your peers, what would the topics be titled?

If you could speak with one or two industry experts, who would you choose?


Do you make the purchasing decisions or make recommendations for purchasing in your organization?

What is your organization's projected budget for new products, services or facilities in the next 12-18 months?

Please list 3-5 suppliers or service providers you'd like to learn more about.

Do you have access to a camera on a computer?

I Agree: If I am selected to participate in the Virtual Summit, I agree to be present for all sessions, meetings, and functions scheduled for the event.

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Please only click the "continue" button once. The application will take a moment to process your responses.