2010 Aquatic Weed Short Course

Step 1 – Contact Information & Participant Profile

Type your contact & affiliation information as it should be recognized; Use upper and lowercase lettering as information will be published exactly as submitted.

The registration process is complete once you receive a printable confirmation form.

Attendee Profile

Required fields are indicated in bold.

Title
First Name
Last Name
Badge Name		The 'badge name' is your full name exactly as you'd like it to appear on your name badge.
Organization
Business Address
City
State
Zip/PostalCode
Province/District
Country
Business Phone
Business Fax
Email Address
CC email to assistant?
Assistant Email
Emergency Contact Name
Emergency Contact Phone (Day)
Emergency Contact Phone (Evening)

Special Needs: Special needs (such as visual, hearing or walking impairments) of registered attendees can be reasonably accommodated if they contact the Office of Conferences & Institutes at least 10 working days prior to the conference. We can be reached by phone at 1-352-392-5930, by fax at 1-352-392-9734, by email at jhanna@ufl.edu If calling from within the State of Florida, the office can be reached at 1-800-955-8771 (TDD).

Please indicate any special needs.

Shirt size
Small Medium Large X-Large XX-Large XXX-Large

Arrival & Departure Dates

Date of arrival:
Date of departure:

Meal Requirements

None Vegetarian Vegan Kosher Other (please specify:)

Short Course Preferences

Are you currently a licensed applicator?

Yes No

Will you be attending the Industry Welcome Reception on Tuesday (5/4)?

Yes No

Indicate all categories you wish to take for the Certification Exam on Thursday (5/6).

	NOT TAKING EXAM
	Natural Area
	Right-of-Way
	Aquatic
	Ornamental & Turf
	General Standards (CORE)
	OTHER (specify)

Additional Comments

Any additional comments that you may have:

Registration Fee Information

The registration fee provides each attendee the educational program, course materials, a Book of Presentations, morning, mid-day and afternoon refreshments and the Tuesday evening Welcome Reception.

Registration Fees
Early Reduced Registration Fee
(By February 26, 2010)
$235.00
Regular Registration Fee
(By April 12, 2010)
$285.00
Late Registration Fee
(After April 12, 2010) $335.00
Student Registration Fee
(Student attendees must fax a copy of their Student ID to Office of Conferences and Institutes at: 352-392-9734 to register.) $110.00

To qualify for fee category, payment must be received by the deadline indicated.

Refund Policy: Requests for registration refunds will be honored if written notice of cancellation is received by the Office of Conferences and Institutes on or before Monday, April 12, 2010. A $50.00 processing fee will be deducted from all refunds. No refunds will be honored for cancellations after Monday, April 12, 2010.

Short Course Attendee	$ 235.00
Student	$ 110.00

Contact Registration Assistance