Teleconference Registration Form

Please complete all fields and questions contained in this form. Once you have filled in all sections, print a copy of the form. Then click the SUBMIT botton at the bottom and we will receive a date-stamped email message containing your registration information. You will still need to print the confirmation page that comes up on your screen after you click Submit and mail a copy of it with your payment.
Early registration fee is $35 up to 7 days prior to teleconference, late fee will be $50 beginning 6 days prior to the teleconference. No refunds will be made once the late registration period is in effect.
Mailing address: NCSU-FEOP, Campus Box 8008, Raleigh, NC 27695-8008
Fax number: 919-515-6883, Our phone number: 919-515-9563

Below are the teleconferences currently available. Which teleconference do you wish to register for? You may choose more than one, but your registration will not be comfirmed until we have received payments for teleconferences you choose. .......................... September 10, 2008 .......................... November 17, 2008 .......................... January 14, 2009 .............................. March 11 , 2009 .......................... May 13, 2009 ................................... June 10, 2009
First Name:
Last Name:
Organization:
Mailing Address:
City, State, Zip
Phone:
Fax:
E-mail:
Confirmation/Map Method:	Send to me by US Mail .......... Email to me and save postage.
$35 or $50 Payment Method:	Check to "NC State University" .......... Mastercard or Visa
Space to hand write your credit card information.	Card number: __ __ __ __ - __ __ __ __ -__ __ __ __ -__ __ __ __ Expiration Date: ___________


Which teleconference site do you prefer? Remember that sites may reach capacity before we receive your registration. We will call you if this happens to discuss other locations.
Alleghany High School, Sparta, NC Brunswick Community College, Leland, NC Elizabeth City State University, Elizabeth City, NC Gateway Technology Center, Rocky Mount, NC Montgomery Community College, Troy, NC Mountain Horticulture Research Center, Fletcher, NC	McKimmon Center at NCSU, Raleigh, NC Southside Virginia Community College-South Hill, VA UNC-Pembroke, Pembroke, NC Vernon James Research Center, Plymouth, NC Western Carolina University, Cullowhee, NC