OMB 0518-0032 (09/2012)

2nd Annual BARC-UMD Fall Symposium:
Trends in Agriculture

Thursday, October 18, 2012

Patuxent Wildlife Research Center
12100 Beech Forest Rd. Laurel, MD 20708-4039

Registration Form

Early registration is encouraged as walk ins will not be guaranteed a lunch

Instructions

• Use your mouse to click on each line
• Type the requested information
• Click the "Submit" button when finished

"*" Required Field

Name
*Last:     *First:

Other:

Institution/Affiliation:

Mailing Address
Street:

City:

State:

Zip/Postal Code:

Country:

Electronic Contacts
Telephone:

*E-Mail Address:

Posters
Will you be presenting a poster?     Yes     No

Title of Poster:

Abstract Preparation Instructions

Send abstract with subject heading "Fall Symposium 2012" to:     rlawson66@verizon.net

Registration Fee
Registration fees cover conference documents, coffee breaks, and lunches. Please check the appropriate box below then click on the link to the registration fee submission site.

SY/Faculty/SY $25.00    Student or Postdoc $5.00
Retired BARC-UMD Scientists Free

   

Registration Fee Submission Site
http://www.far-b.org/BARC-UMD%252520SYMOPIUM.html

Registration will not be complete without payment.

Registration Confirmation
Confirmation of registration will be sent ONLY by E mail. If you do not include an E mail address, we will not send confirmation of your registration.

More information at Symposium's web site: /ba/fallSymposium2012

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