Field Geology Services Short Courses Registration Form Page


Note: You may fill out this form then either print it and mail it to P.O. Box 985 Farmington, Maine 04938 OR simply click "Submit Form" at the bottom of this page to automatically email it to Field Geology Services.

Please provide the following contact information (* = Required):

First Name*
Last Name*
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
FAX
E-mail*

Please provide the following registration information:

        Using Fluvial Geomorphology in Watershed Assessment and Stream Restoration

Course/Dates/Location Amount # of People Total
 
May 28-29, 2008 in Lebanon, NH / White River Junction, VT $345X =
Field Trip on May 30 $175 X =
        

Subtotal

Discounts (Apply both if possible)
Non-profits, government agencies or educators/students $25X =
Groups of 2 or more$25X =
Early Registration (prior to April 30, 2008) $25X  

Sum of Discounts

Total Due (Subtotal minus Total Discounts)

BILLING
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