SHRUG 2004 - Individual Mail-In Training Registration Form

The Seven Hills Regional User Group for GIS
Third Annual GIS Workshop
"Mapping our Future"

2004 SHRUG INDIVIDUAL Training Registration Form
To register individuals by submitting payment via Check, Money Order, PO, or Credit Card.

Reminder: Workshop Registration and Training Registration are separate forms. If you are attending the Workshop you must register for the Workshop separately.

Attendee First Name:

Attendee Last Name:

Attendee Organization:

Attendee Title:

Attendee Address 1:

Attendee Address 2:

Attendee City:

Attendee State:

Attendee Zip:

Attendee Phone:

Attendee E-mail:

	Price	Date	Course
FULL			Introduction to ArcGIS I
FULL			Advanced Analysis using ArcGIS Desktop
	150.00	Nov. 15-16	GPS Training Workshop
	60.00	Nov. 16	Managing GIS Implementation: URISA

*** Billing Information if different than attendee.

Billing First Name:

Billing Last Name:

Billing Address 1:

Billing Address 2:

Billing City:

Billing State:

Billing Zip:

Billing Phone:

Billing E-mail:

Billing Credit Card Type:

VISA MC AMEX PO Vendor

Account Number:

Expiration Date:

VIN Number:
[Front of AMEX, back of VISA/MC]

MAIL TO:
SHRUG, Inc.
Attn: Training Registration
PO Box 3887
Tallahassee, FL 32315-3887

For more information regarding Training Registration please contact Patrick Pence registration@shrug-gis.info (850)891-4941