2010 Symposium Online Registration

West Virginia Mine Drainage Task Force

Ramada Inn, Morgantown, West Virginia
March 30-31, 2010

Bolded fields are required

Name:

Company or Agency:

Address:

Telephone:
ext:

E-mail:

Registration Fees:

  • By March 12, 2010 - $125 / After March 12, 2010 - $150
  • Students - $25
  • Speaker

Method of Payment:

  • Sending check
  • Credit Card
  • Credit card information will be sent through unsecured transmission. Those wishing to give credit card information over the phone rather than online must call Becky Casteel at 304-293-2565.
  • Speaker comp

Credit card information:

Card type:

Credit card number:

Name on credit card:

Expiration date :

Credit card address (if different from above):