Turfgrass and Landscape Registration Form and Payment Options (click here)

TURFGRASS AND LANDSCAPE INSTITUTE

DECEMBER 16, 2009

ETIWANDA GARDENS

7576 ETIWANDA AVENUE

RANCHO CUCAMONGA, CA

TO PAY BY CHECK/MONEY ORDER OR PURCHASE ORDER #:

FILL IN REQUIRED INFORMATION, PRINT FORM AND MAIL IT IN ALONG WITH PAYMENT TO COMPLETE THE REGISTRATION

CREDIT CARD PAYMENTS:

FILL IN REQUIRED INFORMATION AND CONTINUE TO THE PAYMENT PAGE IN ORDER TO COMPLETE THE REGISTRATION

Questions regarding registration please contact Janet Hartin at (951)313-2023 or jshartin@ucdavis.edu

* = Required
Question	Response
* NAME:
ADDITIONAL REGISTRANTS: ^{IF APPLICABLE}
* EMAIL ADDRESS (contact person):
EMPLOYER NAME:
* COMPLETE MAILING ADDRESS:
DAYTIME PHONE #: ALTERNATE PHONE #: FAX #:
IF PAYING BY CHECK/MONEY ORDER OR USING A PURCHASE ORDER #, PLEASE PRINT THIS PAGE AND MAIL IT IN WITH YOUR PAYMENT TO COMPLETE YOUR REGISTRATION
* PAYMENT METHOD:	CHECK/MONEY ORDER (Payable to UC REGENTS) PURCHASE ORDER # (Gov't only) CREDIT CARD
AFTER DECEMBER 11TH AND AT THE DOOR, PRICE WILL BE $120.00 EACH
NUMBER OF REGISTRANTS:	$85.00 Quantity:
ONLY IF YOU ARE REGISTERING FOR 3 OR MORE PEOPLE AT ONE TIME DO YOU SELECT THIS OPTION
NUMBER OF REGISTRANTS:	$75.00 Quantity:
MAKE CHECKS/MONEY ORDER PAYABLE TO: UC REGENTS MAIL REGISTRATIONS TO: UCCE/CHERYL EGGLESTON; 777 E. RIALTO AVE.; SAN BERNARDINO, CA; 92415 QUESTIONS CONTACT JANET HARTIN -- (951)313-2023 OR JSHARTIN@UCDAVIS.EDU