| CENTRAL PLAINS IRRIGATION CONFERENCE
February 25-26, 2014, Burlington Community Center, Burlington, Colorado
COMPANY (Type or print clearly)
COMPLETE MAILING ADDRESS ________________________________________________________________________
Phone, Fax and Email _________________________________________________________________________________________________
(in case of questions about your registration)
NAMES OF THOSE ATTENDING FOR NAME BADGES (Type or print clearly)
Registration is $80 if postmarked by Feb. 7, 2014. After that, it is $90.
For CCA CEU credit, add $15 to be $95 before Feb 7, 2014 or $105 thereafter.
Registration includes admittance to all sessions, the equipment exposition, breaks and 2 lunches.
Registration fee: $__________($80 or $95 before Feb 7 and $90 or $105 after Feb 7) X __________ (Number attending)
Total amount enclosed is: $_______________________
Make checks payable to CPIA. Sorry, no credit cards.
Please return this form with your earlybird payment by Feb 7 to:
Donna Lamm, executive assistant 760 N. Thompson. Colby, KS 67701
The Association's EIN/TIN is 47-0761818 for those needing that number for fee payment.
Phone/fax 785-462-7574 or email@example.com. Sorry, no faxed registration without mailed payment and CPIA cannot accept credit cards.
A block of rooms
has been reserved at the Comfort Inn, 282 S Lincoln St,
and also the Best Western, 605 S Lincoln St,
CEUs for Crop Consultant Advisors have been applied for.
Click here for detailed program
Click here for exhibitor registration