REGISTRATION APPLICATION

Springs Inventory and Assessment Workshop

May 17-18, 2017, Flagstaff, arizona

cost

Regular Rate - $345
Early discounted rate until January 10, 2017 - $295
Student Rate - $175
 

Instructions

Springs Stewardship Institute
Attn: Jeri Ledbetter
3101 N. Fort Valley Rd.
Flagstaff, AZ 86001

Please fill out the required fields on the form below.

You may either pay for your registration using a Credit Card or mail a check to the following address -->

Important!

+ After clicking "Submit" you will be directed to a page that will provide you with a link to our checkout page. Follow this link to complete your credit card transaction.

++ If you are a student and would like to receive a Student Rate, please indicate your status as a student in the application. You will then need to provide contact information for your university registrar. After we receive verification of your enrollment we will send you a link to our Student Rate checkout page for you to receive the Student Rate (50% off full registration cost).

+++ After we receive your registration application and payment confirmation, we will send you an email confirming your reserved spot in our workshop.

Name *
Name
Address *
Address
Phone *
Phone
Please provide the name of your organization, foundation, university, or other affiliation.
Please select if you are registering as an Early Bird (before May 10), Student (must provide proof of enrollment), or at Regular rate (all who register after May 10, 2015).
(STUDENTS ONLY) Please provide your Student ID # and University Registrar's contact information to verify your enrollment at a 2 or 4 year university or college.
Emergency Contact *
Emergency Contact
Emergency Contact Phone *
Emergency Contact Phone
Please provide any additional information or comments in the text area below.