NGWA Standard Bearer Network application

A standard bearer is a person who is interested in taking an active role establishing open lines of communication and ongoing dialogue with U.S. Represntatives and Senators, advocating for the groundwater industry in your local community.

If you are interested in signing up for the NGWA Standard Bearer Network, please fill out the following information, enter the security code in the box provided, 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 Sue Avedikian.

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.
For security reasons, please enter the security code NGWA11 in the box shown below. Do this before clicking submit. Only click once.

Note: It may take a few seconds to submit the file. A new page will open when your form has been successfully submitted.