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2008 Crop Injury Diagnostic Clinic Registration Form

Preferred date of clinic you wish to attend
 July 22-23       July 24-25

Attendance will be limited to 70 people at each clinic. If your preferred date is filled, can you attend the alternate date if notified?   Yes   No

Name:  
Daytime Phone:  --
Organization:  
Address:  
City, State, Zip:  
E-mail Address:  

Session Choices

In the boxes below, please rank the 11 session choices in your order of preference by placing the alphabetical letter of each session in the box below the session choices. For example, if your first choice is Session C, you will place a C in the box below #1.

  1. Water Deficit Stress and Drought Tolerance
  2. Nutrient Deficiencies and Soil Properties Related to Organic Matter
  3. Land Use Management for Conservation and Wildlife
  4. Stored Grain Insects
  5. Herbicide Injury and Symptomology
  6. Invasive Plant ID
  7. Biofuels- Potential and Reality
  8. Selecting the Right Nozzle....Calibrating for Optimum Crop Protection Performance
  9. Use of Grass Buffers to Reduce Herbicide Transport
  10. Field Crop Insects
  11. Field Crop Diseases and Missouri Weather Patterns and Resources

Top Priority...................................................................Low Priority
1234 5678 91011

All attempts will me made to honor the wishes for each person, but in order to balance concurrent sessions, some alternates may need to be scheduled.

Social Dinner
Please indicate whether you plan to attend the free dinner on the first night of the program.
 Yes  No

Fees:
Registration Fee postmarked on or before July 11, 2008.....................$150
Registration Fee postmarked after July 11, 2008.................................$170

Please make check payable to: University of Missouri

Credit Card Payment:   MasterCard   VISA   Discover

Card Number:  
Expiration Date:  
Cardholder's Name:  
(as it appears on the card)

 

Cardholder's Signature_____________________________________________

Registration Options

By Mail
Mail the completed registration form with your check or credit card information to:
Crop Injury Diagnostic Clinic
Bradford Research & Extension Center
4968 Rangeline Road South
Columbia, MO 65201

By Fax
Fax the completed registration form with your MasterCard, VISA, or Discover number to: (573) 884-5554

By Phone
(573) 884-7945 and ask for Thresa Chism. If registering by phone, please have 11 session choices completed and available.

If you have any needs as addressed by the American Disability Act, please contact Thresa Chism at (573) 884-7945.