NGWA Standard Bearer Network application

If you are interested in signing up for the NGWA Standard Bearer Network, please fill out the following information and press the submit button. Thank you for your interest in helping promote groundwater protection in the nation.

If you have any questions, please call 800 551.7379 and ask to speak with Chris Reimer or Sheila Mercer.

Name
Title
Company
Address 1
Address 2
City
State
Zip
Phone
Fax
E-mail
Are you an NGWA member?
List other organizations of which you are a member:
Do you have special connection with any of your congressional members (e.g., close friend, know on first-name basis, worked or contributed to campaign). If so, please identify.
Comments:

Please only click on the submit button once; it may take a few seconds to submit the file.
A new page will open when your form has been successfully submitted.