Hydrophytic Registration Form

A printer-friendly Adobe Acrobat® pdf form can be obtained by clicking here

or you can print out the form below.

Hydrophytic Vegetation Workshop

First Name_________________________________ Last Name_________________________________

Name to Appear on Name Tag____________________________________________________________

Company/Affiliation___________________________________________________________________

Mailing Address_______________________________________________________________________

City_______________________________________State ________________ Zip __________________

Country_______________Phone ( )________________________Fax ( )___________________

email address______________________________________________________________________

We cannot offer confirmation without a valid email address!

Workshop registration will be confirmed via E-mail the week of March 4, 2002.

Hotel Reservations must be made directly with the Holiday Inn by calling 1-800-548-3030 or by using the accompanying hotel registration form. Please register early as the number of rooms are limited.

Registration Fee includes:

Admission to Oral Presentations..........Program/Abstract Booklets..........Social Events

Registration Fees

Early Registration Fee (Postmarked by March 4 , 2002)	$140.00
Late Registration Fee (Paid after March 4 , 2002)	$160.00
Early Student Registration Fee (Postmarked by March 4 , 2002)	$50.00
Late Student Registration Fee (Paid after March 4 , 2002)	$65.00
One Day Early Registration Fee (Postmarked by March 4 , 2002)	$80.00
One Day Late Registration Fee (Paid after March 4 , 2002)	$105.00
2 or 3 Day Registration Fee	Same as Full Week Rate
Half Day Registration Fee	Same as Full Day Rate

CREDIT CARD PAYMENT INFORMATION

Circle Credit Card

VISA MASTERCARD AMERICAN EXPRESS

Credit Card #______________________________________Expiration Date:_____________

Name As Appears on Credit Card:________________________________________________

Signature:_______________________________________Amount_______________________

Payment must accompany this registration form. Payment must be Postmarked by March 4 , 2002 for participant to qualify for early registration rate. Cancellations must be received in writing by March 4 , 2002. The cancellation fee is $40.00. There will be no refunds after this date.

*Make check payable to:

The Wetland Regulatory Group

67 Meyer Lane

Stafford, VA 22554

Phone: (540) 286-0072

Fax: (540) 286-0073 E-mail: Frank@TheReillyGroup.net

Contact Information

The Reilly Group

Telephone: (540) 286-0072
FAX: (540) 286-0073
Postal address: 67 Meyer Lane
Stafford, VA 22556-3430
Electronic mail: General Information: Frank@TheReillyGroup.net
Webmaster: webmaster@TheReillyGroup.net