JPIA Spring Conference Registration

2026 JPIA Spring Membership Summit

Name *

First

Last

Title *

If other, please Specify:

Email *

Address *

Address Line 1

City

State

Zip Code

Phone *

Please use the phone number associated with the participant attending the Membership Summit (cell phone).

Member Agency Representation (or Non-Member) *

Member Agency

Name of non-JPIA member Agency that you represent

Are you the designated ACWA JPIA voting representative for your member agency? *

FPPC Form 700 Compliance (Required for Voting Members) *

I acknowledge that I am the designated JPIA Director or Alternate Director for my agency. I further acknowledge that JPIA Directors are required to have a current FPPC Statement of Economic Interests (Form 700) on file in order to serve and vote in good standing on the ACWA JPIA Board, and that I will submit this form to ACWA JPIA if it is not current.

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