Third Northern Plains Winter Storm Conference             25-26 September 2008

Registration Form (deadline Wednesday, September 10, 2008)

Cost:

(1 Luncheon, Morning/Afternoon Snack Breaks Included)

Name: ______________________________________________________________

Street Address: ______________________________________ _________________

City: ________________________________________________________________

Zip/Postal Code: ______________________________________________________

Work Phone: _________________________________________________________

Cell/Alternate Phone: __________________________________________________

Email Address: _______________________________________________________

Company/Institution: __________________________________________________

Payment Information:

Payment made by credit card, check, or money order. Make check payable to: Saint Cloud State University

Credit Card Info (circle MasterCard or VISA)

Name as on Card: _______________________

Address of Card Holder: (if different than above) ______________________________

City/State/ZIP _________________________________________________

Card Number: _________________________ Expiration Date: ________

Security Code (on back of card): ___________________

Please send registration form to:

Saint Cloud State University

Department of Earth and Atmospheric Sciences

WSB 41

720 Fourth Avenue South

Saint Cloud, MN 56301-4498

Phone: (320) 308-3260

FAX: (320) 308-4262

Thank you for supporting and attending the Third Northern Plains Winter Storms Conference!

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Last Updated: August 19, 2008

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