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2002 LAND USE PLANNING WORKSHOPS— February-June <br /> REGISTRATION FORM <br /> (Please print or type. Form should be duplicated when registering more than one person!) <br /> First Name 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 <br /> Last Name 1 1 1 1 1 1 1 1 1 [ 1 1 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 <br /> NOTE. PLEASE PROVIDE US WITH YOUR E-MAIL ADDRESS SO WE MAY CONFIRM YOUR REGISTRATION. CONFIRMATIONS WILL BE SENT ONE WEEK BEFORE THE WORKSHOP <br /> Workshop Options: (Check all that apply.): Registration Options: <br /> Annual Planning Institute: The Basics 1$99) Regular <br /> February 14—St. Cloud Student at <br /> March 14—St. Paul <br /> I 1 April 13—St Paul Payment Options: <br /> Beyond the Basics ($125) Enclosed is check# in the amount of <br /> March 13—St. Cloud $ (payable to Government Training Service) <br /> April 24—St. Paul Please bill me at above address <br /> May 4—St. Paul P.0# (if applicable). <br /> Advanced Zoning Applications NOTE:AN$8/AGENCY BILLING FEE WILL BE ADDED TO THE <br /> Brown Bag series-St. Paul ($99) AMOUNT OWED. BILLING OPTION NOT AVAILABLE TO STUDENTS. <br /> (2/13 - 3/13 - 4/10 - 5/15) <br /> • April 25—St. Cloud ($1251 <br /> May 8 -St. Paul ($125) Special Needs: (Must be received at least two weeks <br /> Building Community Character ($125) before the workshop for which you are registering.) <br /> I May 15—Breezy Point I have a dietary restriction (e.g., vegetarian)as <br /> Environmental Planning ($125) follows: <br /> April 11 -St. Paul I require ancillary aids(i.e. sign language <br /> Boundary Adjustments ($50) interpreter, large print, Braille materials, etc.). <br /> June 26 -St. Cloud Please contact me at: <br /> Technology Tools for Local Planning ($50) (Circle one: VOICE or TM <br /> I require other accommodations. Please contact <br /> April 17—Grand Rapids me at: <br /> May 1 —Mankato <br /> _ May 16 —St Cloud <br /> Return this form at least seven days prior to the first workshop you are attending to: <br /> Government Training Service, 480 Cedar Street, Suite 401, St. Paul, Minnesota 55101-2240 <br /> (or fax if you have selected the"bill me"option to: 651-223-53071. <br /> • <br /> • <br />