INDEPENDENT WATER AND SEWER COMPANIES OF TEXAS, INC.

4833 Spicewood Springs Road, Suite 202

Austin, TX  78759

 (512) 346-4011          IWSCOT@austin.twcbc.com      Facsimile (512) 346-6847

APPLICATION FOR MEMBERSHIP

Name of Utility/Company/Firm _________________________

Mailing Address ____________________________________________________________

 City _________________ State ____________  Zip ____________  Phone _____________

Official Representative Name __________________________  Title ___________________

Contact email address: ______________________________________

Type of Membership (Check One): ______ Regular (Voting) Membership (Utility Only)

                                                    ______ Associate Member (Trade or Professional)

If Applying for Regular Membership, indicate number of Customers:

  ___________ Water   ____________ Sewer

Note: Annual dues for regular customers are determined annually and are based on number of customers.

Utility Consultants (If Applicable):

Attorney __________________________ Engineer ____________________________

Accountant ________________________ Rate Specialist ________________________

Referred/Sponsored by: ____________________________________________________

Description of Associate Applicant’s Products or Services:

______________________________________________________________________________

I hereby apply for membership in the Independent Water & Sewer Companies of Texas, Inc.

______________________________________          Date:  _______________

Please mail, email, or fax this application to the address above.  Dues are prorated with annual dues being due as of January 1 of each year.