The 18th Annual Training Workshop 

Registration Form

Thursday, April 2, 2009

At the St. Martin Community Center - 15008 Lemoyne Blvd, Biloxi, MS

**Please print & complete this registration form and fax it to us at 228-392-0553**

Call Trisha with any questions concerning registration @ 228-392-2085

 

Persons Attending   _______________________________   Water / WW / Both

                                        _________________________________    Water / WW / Both

                                        _________________________________    Water / WW / Both

                                        _________________________________    Water / WW / Both

 

Water System / Organization    ________________________________

Address________________________________________________

               ________________________________________________

               ________________________________________________

Phone    _____________________    Fax    _____________________    

*Email Address_____________________________________________

*(please add your email address so that we may easily contact you if necessary)

 

Crawfish Boil at our shop afterwards, 15413 Lemoyne Blvd, just down the street

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