Registration form if paying with check

REGISTRATION FORM

Register by November 4, 2005!

I want to register for:

FIELD TRIP IS SOLD OUT!

Workshop $300.00

Students Workshop $150.00
(Bring Student ID)

Workshop Only $250.00
xxxx(Prior to 11/04/05)

Workshop Only $300.00
xxxxx(After 11/04/05)

Students Workshop Only$ 150.00
(Bring Student ID)

Make check payable to:

University of Arizona

Mail to:

University of Arizona, School of Natural Resource
ATTN: Carol Heil
P.O.Box 210043
Tucson, Arizona 85721-0043

First Name: Last Name:

Organization:
Street Address:

City: State: Zip:

Phone (including area code)

Contact E-mail:

REQUIRED: Please mark your first and second choice of the break-out session you wish to attend on Friday, December 9th:

First choice (pick one)	Second choice (pick one)
		Pre-fire Risk Assessment, including Fuels Mapping and Treatments
		Fire Ecology and Wildfire Effects
		Post-fire Restoration and Rehabilitation
		Fire Incident Response and Operations Support

PRINT COPY OF THIS FORM FOR YOUR OWN RECORDS AND INCLUDE A COPY WITH PAYMENT OF YOUR CHECK.