for additional lodging options.
All registrations received by Jan. 30, 2010 will be entered in a drawing for a free registration for the
2010 Weed & Pest Conference
Registration Form
Please detach and return with payment by February 10, 2010.
Make check payable and send to:
Weed & Pest Conference
c/o Gary Pribyl
19987 Homestead Lane
Wolsey, SD 57384-8425
___ # of Registrations Supervisors Training (Wednesday) @ $25.00 $______________
(breaks & noon meal included)
___ # of Registrations Conference @ $90.00 (Thursday and Friday) $______________
(2 breakfasts, all breaks, 1 noon meals & awards banquet included)
___ # of Registrations @ $65.00 (Thursday) $______________
(breakfast, breaks, noon meal & awards banquet included)
___ # of Registrations @ $30.00 (Friday) $______________
(breakfast, 1 break included)
Total enclosed $______________
Payment must be enclosed.
Please include the following information for each person included with this form. Print carefully as name tags will be prepared from this information.
Name_____________________________________________________
Title______________________________________________________
County/Agency_____________________________________________
copy as needed
.