REGISTRATION

REGISTRATION

Coordinated Management
of Water Quality Protection
and Food Safety Initiatives Conference

Promoting Coordinated Management of
Water Quality Protection & Food Safety Initiatives
in California Vegetable Production

Monday, April 23 - Wednesday, April 25, 2007
Embassy Suites, San Luis Obispo, CA

* = Required
Question	Response
Every person attending the conference must submit a separate registration form. This form is suitable for registration and payment by credit card ONLY.
*Registration Deadline APRIL 1*
* First Name
* Last Name
* Email
* Organization/Agency
* Job Title
* Name as it should appear on your badge
* Address Line 1
Address Line 2
* City
* State
* Zip
* Phone
* My involvement in the conference will be as a:	Participant Speaker/Panel Session Moderator Workgroup Facilitator
I am interested in participating in the poster session:	Yes No
I would like for these topics to be addressed:
I would like to have more information about:
Special needs:
Conference fee	$140.00 required charge
A registration confirmation will be emailed to you once registration is completed. You must be on the invitation list to register. Cancellation deadline is April 10.