Demonstration site-class-registration-form
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The document announces an upcoming training event on May 18th in Springfield, Missouri about Ozark soils, sinkholes, and onsite wastewater troubleshooting. The training will run from 8am to 4pm at the C.W. Titus Education Facility. Light breakfast and lunch will be provided. Registration is required by May 15th and costs $20 per person. The event is anticipated to offer 4-5 continuing education units. Attendees should complete the registration form and send with payment to the Missouri Smallflows Organization.
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Demonstration site-class-registration-form
- 1. Ozark Soils, Sinkholes, and Onsite Troubleshooting at the Onsite Wastewater Training Site in Springfield, Missouri Date: May 18, 2012 Time: 8:00 a.m. 4:00 p.m. Check in begins at 7:30 a.m. Light breakfast refreshments provided by Table Rock Lake Water Quality Lunch provided by Missouri Smallflows Organization Cost: $20 per person (Anticipated 4-5 CEUs, pending approval) Registration required by May 15 (confirmations will be sent via email) Location: C.W. Titus Education Facility at the Watershed Center 2450 E. Valley Water Mill Road, Springfield, MO Directions: See second page Please detach this portion of the form and send to the Missouri Smallflows Office with registration payment. Name: ______________________________________ Address: _____________________________________________________________________ Phone Number: __________________________ Email Address: __________________________________________________________________ Confirmations will be sent by email. State License Numbers Installer #_______ Inspector #_________ OSE #__________ Perc Tester #______ Send registration form and check Add a $5 convenience fee for all credit card payments via mail or fax credit card Check here if card billing address same as above payment to: Card #: ____________________________________________ Missouri Smallflows Organization P. O. Box 606 Exp: ___/____ CVV: ________ Kimberling City, MO 65686 Name on Card: ____________________________________ Phone: (417)739-4100 Fax: (417)739-9889 Card Billing Street Address: _________________________ Email: contact@mosmallflows.org Card Billing ZIP code: _______________________ Website: www.mosmallflows.org