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:x <br /> MRWAPre-registrationForm <br /> This formmust be received no later than February 20,2004 for pre-registration rates to apply. <br /> ", fo Minnesota Rural WaterAssociation,21712th Ave SE,Elbow Lake,MN 56531. <br /> Plecompleteoneformforeachregistrant.Guest mayuse same registration form. <br /> First Name_' Last Name <br /> tiF <br /> SystemOir. <br /> Systems: ddress <br /> I I I <br /> I I I I <br /> Zip Telephone <br /> s Name(if registering) w ForOffice Use only <br /> checkoneofthefollowing: ' Date reed <br /> ' Check# <br /> ger/Operator Council/Board Member Mayor Amount <br /> Acinistrative/Clerk Industry Spouse Other Receipt # <br /> Initials <br /> DON'T MISS THIS SPECIAL <br /> 15.00 discount on registration price for Mayors, Clerks and Councilpersons attending for the first-time. <br /> Must be accompanied by system operator or manager. <br /> tration Postmarked prior On-site Registration <br /> es access to all sessions,Exhibit Hall, to February 20,2004 <br /> a theme party. <br /> $ MRWA Associate Member $100.00(per person) $125.00(per person) <br /> $ Non-Member $125.00(per person) $150.00(per person) <br /> $ k_eest $ 40.00 <br /> $ 45.00 <br /> $,.1 e(make checks payable to Minnesota Rural Water Association) <br /> p Register on-line at:www.mrwa.com Select the Training Button. <br /> QA <br /> Print invoice and mail payment to MRWA office. <br /> ~ JPayme>glet'l�+t <br /> Cheer-{ 0 VISA ❑MasterCard <br /> Credit Card No: <br /> CardholderName• <br /> xpiration Date: <br /> Signature: <br /> Cancellation Policy: Fees will be refunded if written request is received by February 20,2004. <br />