Form Test

Name*

Address*

Email*

Phone

Company/Organization*

What is your discipline/role?*

Other

Which sector do you work in?*

Public
Private
Not Applicable

REGISTRATION OPTIONS
Day 1: August 9 - Regional Planning Forum, 1/2 Day
- In Person and Virtual options available
Day 2: August 10 - Main Summit Event, Full Day
- In Person and Virtual options available

August 9 - Regional Planning Forum Registration

August 9 registration options
EARLY BIRD SPECIAL
IN PERSON ATTENDANCE
• Business - $50
• Government, Non-profit, General Public - $35
• Students: $25

AFTER JULY XXX
IN PERSON ATTENDANCE
• Business - $65
• Government, Non-profit, General Public - $50
• Students: $25
VIRTURAL ATTENDANCE
• Everyone – FREE (optional donation of $25)

Would you like to make the optional virtual attendance donation of $25?

Select
Yes
No

August 10 - Main Event Registration

Select this option if you ONLY plan on attending on August 13. EARLY BIRD SPECIAL
IN PERSON ATTENDANCE
• Business - $120
• Government, Non-profit, General Public - $105
• Students: $60

AFTER JULY XXX
IN PERSON ATTENDANCE
• Business - $135
• Government, Non-profit, General Public - $120
• Students: $70
VIRTURAL ATTENDANCE
• Business, General Public - $50
• Non-profit, College/University Employees - $35
• Public Officials, Municipal Employees - FREE

Do you plan on attending happy hour in the Rathskeller Biergarten at the conclusion of the day (~5:30pm) on August 10?*

Happy hour in the Rathskeller Biergarten is an in person, outdoor event. It will include live music, free drinks and snacks.

Yes, I plan to attend for the networking happy hour
No, I don't plan to attend for the networking happy hour

Would You Also Like To Become An ‘Indiana Water Investor’ By Giving A Donation To Support Future Indiana Water Summits?

Yes

Donation Amount

Other Donation Amount

Enter a contribution amount of your choice.

What Type of Donation is this?*

Name of Individual*

First Last

Name of Family or Business*

Do you want to pay via credit card or check?*

Credit Card
Check (please select this option if you chose any of the FREE options above)

Payment Transaction Options*

Yes, I would like to cover the payment transaction fees
No, I don't want to cover the payment transaction fees

Your transaction is securely being processed with a 3% transaction fee to cover credit card, bank fees, and other processing costs. Please consider chipping in an additional 3% so 100% of your donation amount goes to the White River Alliance.

Total Amount Due (including transaction fees)

Price: $0.00

Total Amount Due

Price: $0.00

Credit Card

We do not accept American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Hidden

Collection Type

Programs

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