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2001 LAND USE PLANNING WORKSHOPS — March-May <br /> Registration Form <br /> Return at least 7 days before the first workshop you are attending. <br /> (Please print or type. Form should be duplicated when registering more than one person!) <br /> First Name IH11111111111111111111111II <br /> Last Name 1 1 1 1 1 1 1 1 1 111111 [ 1 1 1 1 1 1 1 <br /> Title <br /> Jurisdiction/Agency How long in this position? <br /> Street Address <br /> City State Zip <br /> Daytime Phone Fax Number E-mail lit available) <br /> Note: e-mail will be used to send your confirmation. <br /> Workshop Options: (Check all that apply.): Registration Options: <br /> Annual Planning Institute:The Basics ❑ Regular <br /> ❑ March 24-Earle Brown,St. Paul <br /> ❑ March 28-Radisson,St.Cloud ❑ Student at: <br /> ❑ April 11-Earle Brown,St.Paul <br /> Payment Options: <br /> Beyond the Basics ❑ Enclosed is check# in the amount of <br /> ❑ April 5-Best Western,St.Cloud $ (payable to Government Training service). <br /> ❑ April 21-Earle Brown,St.Paul ❑ Please bill me at above address. (This option is not <br /> ❑ May 9-Earle Brown,St.Paul available to those registering at the student rate.) <br /> P.O.# (if applicable). <br /> Advanced Zoning Applications NOTE:An$8/agency billing fee will be added to the <br /> ❑ April 26-Earle Brown,St.Paul amount owed. <br /> ❑ May 10-Holiday Inn,St.Cloud <br /> Special Needs (Must be received at least two weeks before <br /> Building and Sustaining Community Character the seminar for which you are registering.): <br /> ❑ March 29-Holiday Inn St.Cloud ❑ I have a dietary restriction(e.g.,vegetarian)as follows: <br /> ❑ April 25-Earle Brown,St. Paul <br /> Environmental Planning & Compliance ❑ I require some ancillary aids(i.e.sign language interpreter, <br /> ❑ May 2-Earle Brown,St.Paul large print,Braille materials,etc.). Please contact me at: <br /> Boundary Adjustments (Circle one:VOICE or TTY) <br /> ❑ April 26-Arrowwood,Alexandria 0 I require some other accommodations. Please contact me <br /> ❑ May 9-Radisson,St.Cloud <br /> at: <br /> ® 1interested in participating in a future;b ,,. s own bag fdncfr* esslong' e •(• • <br /> Planning Vtlorkshop(s)in the metro area Li yes ,, � <br /> What time of year(please check all that applyt, •; . ` 3 l' <br /> summer a • , i",'Sr.:ii <br /> What locations(please checkall that apply)? ❑ St.Paul ❑Minneapolis - ❑ •- . t � <br /> ❑ Southern suburbs • '{ <br /> ❑Western su <br /> i <br /> Return this form at least seven days prior to the first workshop you are offending to:Government Training Service,480 <br /> Cedar Street,Suite 401,St.Paul,Minnesota 55101-2240(or fax if you have selected the"bill me"option to:651/223-5307). <br />