WaterISAC Pro Registration

Organizations that are eligible to subscribers to WaterISAC Pro are:

Drinking Water and Wastewater Utilities in the U.S. and Canada
State Water and Wastewater Agencies
U.S. EPA
Others approved by WaterISAC's Board of Directors

To subscribe, the primary user must complete this form. The primary user is the main contact with WaterISAC with regard to the organizations' subscription.

In cases in which a company operates a water or wastewater system under contract, then the system itself, and not the contract operator, must be the subscribing organization.

WaterISAC reserves the right to disapprove any request to subscribe.

By subscribing, your organization expressly agrees that it and its designated users will fully comply with the Terms and Conditions.

*: indicates a required field

Primary User Information

First Name:	*
Last Name:	*
Title:	*
Organization:	*
Address 1:	*
Address 2:
City:	*
State/Province:	*
ZIP/Postal Code:	*
Country
Direct Phone #:	*
Mobile Phone #:	*
Mobile Phone Service Provider:	* (for text-messaging)
Home/Alt. Phone Number:
Email Address:	*
Alternative Email Address:

Organization Information

Type of Organization * Combined Drinking Water and Wastewater Drinking Water Only Wastewater Only
Parent / Subsidiary Structured Water or Wastewater Company Corporations owning multiple drinking water or wastewater systems should subscribe on a state-by-state basis. All systems under a parent company in a particular state should combine the population served by those systems and submit one subscription agreement as if a single entity. Users may be located at any of the facilities across the state. Each system must be listed below.
Service population (individuals, not accounts) *

Information on Users to Have Access to the WaterISAC

Each additional user within your organization must be listed below.
Name	Email Address

Subscription Payment Information

Utility Size/Fee Category

Service Population	Annual Fee for Primary User	Annual Fee for Each Add'l User
More than 100,000	$1,000	$500
50,000 to 100,000	$500	$250
Less than 50,000	$200	$100

Total Number of Users: 1

Total Cost: $

Select Payment Type:

Check/P.O. (Mail to: WaterISAC, 1620 I Street NW Suite 500, Washington, DC 20006)

Credit Card

Card Type:
Card Number:
Exp. Date:
CC Verification:
Billing Address (if different than Primary User address above)
Address 1:
Address 2:
City:
State/Province:
ZIP/Postal Code:
Country

Do you need a W9 from WaterISAC? Yes No

As a WaterISAC Pro user you must prevent the inappropriate dissemination of information that you will see on the secure website. Also, you must prevent access to the secure website by non-WaterISAC Pro users. The inappropriate release of WaterISAC information could cause harm to the Nation, its allies, water and wastewater systems, consumers and WaterISAC, itself.

Therefore, each user must read, understand and agree to the Terms and Conditions for subscribing to WaterISAC Pro. Indicate your consent to the Terms and Conditions by initialing the box below. Please contact WaterISAC with any questions.

I have read, understand and agree to WaterISAC's Terms and Conditions.
(Enter initials)

Become a Subscriber

WaterISAC Pro Add a User

WaterISAC Pro Replace a User

WaterISAC Pro Registration

Primary User Information

Organization Information

Information on Users to Have Access to the WaterISAC

Subscription Payment Information