Registration form - Earth-KindŽ Rose Symposium
                           Saturday, October 17, 2009 - 8:00 a.m. to 5:30 p.m.

Complete this form and mail with your check. 
Register early. Space is limited.

Name: ________________________________________

Address __________________________________________________________________________

Telephone # __________________________Email _________________________________
(You will receive confirmation by email. Because of expenses incurred by VCMGA, ticket costs are non-refundable.)

Amount Enclosed $ _________ ($65.00 if postmarked by Oct. 9, or hand delivered to the EXtension Office, 442 Foster Field Drive, Victoria Regional Airpot, by  noon on Monday, Oct 12.

Checks payable to
Mail checks to
VCMGA, P. O. Box 1723, Victoria, TX 77902.

Individuals with disabilities who require an auxiliary aid, service or accommodations in order to participate in these meetings are encouraged to contact the County Extension Office prior to Oct. 9, at (361) 575-4581 to determine how reasonable accommodations can be made.