NRCA Weed Control Seminar Registration
January 30, 2017- February 2, 2017 SN20075/SA/17FY
Training materials for Session I, Core and Category 6 manuals can be obtained from the Media Distribution Center, Purdue University: 888-398-4636.
You may download and print the 2017 NRCA Seminar Program
You may download and print 2017 Program Registration to register
OR register on-line at: www.conf.purdue.edu/nrca2017 Program Registration
OR Fill in all information below and
Mail to: Purdue Extended Campus Business Services OR FAX: 765-494-0567 Purdue University
Stewart Center, Room 116
128 Memorial Mall
West Lafayette, IN 47907-2034
Enroll the following person in the NRCA Weed Control Seminar, SN20075/SA/17FY
Register by January 14, 2017.
Photocopy this form for each registrant.
There will be a $50 late fee for each person registered after this date.
The cancellation date is January 14, 2017. If you cancel before January 14, you will receive a full refund, but if you cancel after January 14, there will be no refund. Any cancellation refund request after January 14 will be considered on a case by case basis by Dr. Reid Smeda.
Name _________________________________________Title ___________
Company ______________________________Address __________________
City _____________________________________ State ______ Zip ________
Social Security number________________________ Phone _________________
(SSN Required if you are claiming Lifetime Learning Tax Credit)
E-mail Address* ______________________________________________________________
Please sign me up for (CIRCLE) — SESSION 1 —-SESSION 2—-BOTH
|Registration for NRCA member or railroad employee @ $425 per person||$__________|
|Registration for non-NRCA member @ $2,000 per person||$__________|
You will receive an email confirmation from Purdue Conferences regarding your registration.
Make checks payable to Purdue University. Payment required with submission of registration.
Guarantee my registration by credit card:
|____ VISA||____ MasterCard||____ Discover||____ Am Ex|
Account number Expiration date
I have the following dietary restrictions._____________________________________________