Conference Registration

Full Conference Registration is $125.00/person, which includes morning and afternoon refreshments, an evening reception on February 25th (refreshments provided), and an Academic Environmental Management System Startup Kit, provided by the Institute for Environmental Excellence.

Registration for the February 25th Evening Reception only is $25.00/person and includes refreshments and a special presentation by Mr. Steve Mahfood of the Missouri Department of Natural Resources.

Please print the following form and fax or mail it, along with your registration fee to the Institute for Environmental Excellence. Checks and credit cards (Visa, MasterCard or Discover) are accepted. Please make checks payable to the Institute for Environmental Excellence.

_____________________________________________________________________________
Name
____________________________________________________________________________
School/Organization _____________________________________________________________________________
Street Address/City/State/Zip Code
_____________________________________________________________________________
Fax
_____________________________________________________________________________
Phone Number
_____________________________________________________________________________
E-mail

Please check registration information:

____Full Conference Registration ($125.00) ____ Evening Reception Only on 2-25-02 ($25.00)

Payment Method:____Check ____Discover ____Visa ____MasterCard

Card Number:____________________ Expiration Date:__________________

Signature:______________________________________________________

Please fax or mail your registration to:

Missouri S&T Institute for Environmental Excellence
Attention: Dr. Harvest L. Collier, Director
121 Fulton Hall
1870 Miner Circle, Rolla
Missouri 65409-1130
Phone (573) 341-4131
Fax (573) 341-6127