Preregistration Form
Crop Management Field School

 

(Please print or type)

Name  ______________________________________________________________

 

Organization          _____________________________________________________

 

Address       _________________________________________________________

 

City   ______________________________________________________________

 

State _________________________        Zip    __________________________

 

Phone  ______________________________________________________________

 

E-mail address       _____________________________________________________

 

Fee:             $30 per person

Payable to:   Crop Management Field School

 

Return form and fee to:

          Crop Management Field School

          Carrington Research Extension Center

          PO Box 219

          Carrington, ND  58421-0219

          Tel. 701/652-2951          Fax 701/652-2055

 

Requests for accommodations related to disability should be made to Greg Endres at 701/652-2951 by June 20, 2000.

 

Please check any accommodations you may need during the conference:

q    Sign language interpreter

q    FM amplification system

(specify type ____________________________)

q    audio-tape materials

q    sighted guides for assistance to/from specific sessions

q    large print

q    Braille

q    Other _____________________________________

 

Deadline for preregistration is June 20, 2000