NC Broiler Supervisors’ Short Course Multiple Registration Form

You may submit multiple names and titles, but only one company, address, phone number, fax number and email address.

Name(s) (One per line):

Title(s) (One per line):

Company:

Address:

City: State:

Zip/Postal Code: Country (if outside USA):

Phone: Fax:

Email (Required field. This should be the email address of the person submitting the form):

Please select one: A check will be mailed. Will pay at meeting.

REGISTRATION INFORMATION

The registration fee is $50.00 per person, which includes a copy of the proceedings, lunch, snacks and door prizes. Make check or money order in US dollars payable to Agriculture Educational Services Inc.

You can also pay with Credit Card here.

CANCELLATION NOTICE:
Prior to two weeks = No charge
Within last week = Half of enrollment fee
No show = Entire enrollment fee

For additional information contact:

Dr. Edgar O. Oviedo-Rondón
North Carolina State University
Cooperative Extension Service
Department of Poultry Science
229 Scott Hall
Raleigh, NC 27695-7608

Phone: +1 (919) 515-5391
Fax: + 1 (919) 515-7070

E-mail: edgar_oviedo@ncsu.edu

Once you hit submit you will receive a confirmation of your pre-registration. Please print this confirmation for your records.