Nebraska Rural Water Association
3390 Ponderosa Street
Wahoo, NE 68066
Water System Utility Membership Form
Phone: (402) 443-5216
Website: www.nerwa.org
Toll Free: (800) 842-8039
Email: office@nerwa.org
Fax: (402) 443-5274
Utility System
Population
Mailing Address
City
St.
Zip
County
Phone
Fax
Website
Email
Clerk Name
Cell Phone
Mailing Address (if different)
Mayor/Chairman
Mailing Address (if different)
Operator
Operator #2
Address
Address
Cell Phone
Cell Phone
Email
Email
Wastewater Operator
Population
Dues
Address
Up to 300
$100.00
Cell Phone
301-600
$125.00
Email
601-1000
$150.00
1001-1500
$175.00
1501-2500
$200.00
The Delegate will be voting on issues at the NeRWA annual conference
2501-3500
$225.00
Voting Delegate:
3501-5000
$250.00
Alternate Deligate:
5001-10000
$275.00
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