Please submit this form to: (either print out and fill out in pen, or you can fill out the form on the web and hit the submit button at the bottom:

Craig Dremann, The Reveg Edge, Box 609, Redwood City, CA. 94064 (650) 325-7333

PRICE: $250 per person attending the workshop in California.
Outside of California, price is $350. Price includes lunch.

Name of participant:
Department:
Agency:District:
Address:
Town: State: Zip:
Email (important):
Phone:

Check below which workshop the participant will be attending:
BLM SUSANVILLE - USFS Lassen NF S.O., 2550 Riverside, Rooms Caribou 1 & 2 - 9AM-4PM - Tuesday October 2, 2001

PAYMENT: (since this is not an encripted email form, we will not take credit card info. electronically: please either call or fax cradit card information)
Credit card - Call 650-325-7333 with number,
or fill out below and fax this form to (650) 325-4056: Mastercard, Visa
__ __ __ __/__ __ __ __/__ __ __ __/__ __ __ __ , Exp. Date:__ __/__ __

Other (describe)

PLEASE COMPLETE THE SURVEY as your response is used to set the agenda.

WORKSHOP information can be found at http://www.ecoseeds.com/workshop.html

Thank you.