New User Signup

* Signifies fields required to register for workshops
* Signifies minimum fields required to signup
IMOWA User ID** :
Please choose a new, unique
user id that you will
use to login to this site.
IMOWA Password** :
Please choose a password
to use for this site.
IMOWA Password (again)** :
Please type your password again
to confirm you entered it correctly.
First Name** :
Last Name** :
Title* :
Department* :
Institution* :
Leave at *No Location Specified* if your institution is not listed.
Work Address, Line One* :
Work Address, Line Two :
Work City*, State**, Zip* :
Work E-Mail** :
Work Phone* 999-999-9999 :
Work FAX 999-999-9999 :

If you prefer your registration materials to be mailed to a different address or that you be contacted at a different phone number or e-mail address, please list the alternate contact information below:
Alternate Address, Line One:
Alternate Address, Line Two:
Alternate City, State, Zip:
Alternate E-Mail:
Alternate Phone 999-999-9999 :
Alternate FAX 999-999-9999 :

Special Dietary/Accessibility Needs:

Don't send me any mailings
Note: Be mindful of the following information when checking this box:
This will prevent the following e-mails from being sent: (1) automatic monthly password reminders, (2) any e-mail from an IMOWA administrator to the entire membership list (such as IMOWA website update notifications), and (3) any e-mail from a workshop leader to the registrants of a certain workshop

I am requesting the following status for my account:
State Planning Team Member
Workshop Host
Workshop Leader
Note: These special permissions must be set by the Webmaster for the site and should happen within one business day of your request. You will be notified by e-mail when your permission has been set.