Pay for a course with a company check or money order

PLEASE PRINT ONE FORM FOR EACH COURSE PURCHASED.
(One check may be submitted for multiple purchases.)
Full name:
Phone number:
E-mail:
Certification type:
Payment is for:
Amount to enclose:
Special notes:

  Only after filling in all information,
  

Please print and include this page with your payment. If you do not have a printer, simply write down the information requested on this form and include it with your payment.

Make your check or money order payable to the Missouri Rural Water Association and send to:

Missouri Rural Water Association
901 Richardson Drive
Ashland, MO 65010

Note: You will not be able to access the online course for 10 working days after MRWA receives and processes your payment. You will receive an email when you are able to access the course.