2004 Selenium Symposium Registration

November 3-4, Ramada Inn of Grand Forks, ND

Reserve your room at the Ramada Inn (toll-free 1-800-570-3951) by October 15.

Name:
Organization:
E-mail Address:
Phone Number :
Your interests in Selenium: (check all that apply)	Plant Toxicity Grains Vegetables Nutrition Cancer reduction Industry Regulatory Agency Animal Science	Production Marketing Teaching Product Development/formulation Research Extension University State Government Federal Government

Registration includes all meals and breaks listed on agenda and all conference speakers, CD's and handouts.

Please send check so it is received by Oct. 11 to:

    Bev Liebelt - NDSU ARSC
    Accounting Technician
    Hultz Hall 100, NDSU
    Fargo, ND 58105-5727

Payment:
	$25 Full Pre-Registration
	$35 Full Registration Upon Arrival

Vans will be transporting small groups from the Ramada to GRHNC starting at 12:30.

GFHNRC - Check here to sign up for the tour.

Go on a walking tour of GFHNRC to learn more about their research and facilities.

Be sure that your e-mail address is correct at the top of this form so you can receive e-mail confirmation of your registration.