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2010 WAGA IPM Field Day Registration

Questions? Call (800) 722-3120 / (920) 478-9586 (Fax)

Name(s) __________________________________________________________________

Orchard/Business ___________________________________________________________

Address __________________________________________________________________

City ______________________________ State ___________  ZIP ___________________

Phone ____________________________ Email ___________________________________

 Summer Field Day (Wednesday, June 30th, Kickapoo Orchard, Gays Mills, WI) 

______ (qty) WAGA Members: $25.00 each person                      TOTAL: _____________

______ (qty) Non-Members: $37.00 each person                           TOTAL: _____________

Print this form and mail with check to:                       TOTAL AMOUNT DUE: _____________
WAGA, 211 Canal Rd., Waterloo, WI   53594

Price includes refreshments and lunch.

You May Charge on Your MasterCard or VISA if you wish...

Name on Card:  

 

Card Number:  

 

Expiration Date:  

3 Digit Security Code:

 

There will be a limit of 40 participants and only two people from any orchard.  Please register by June 28th so that we may have an accurate count for lunch.