The Seven Hills Regional User Group for GIS
Ninth Annual GIS Workshop
"Map It Forward"

2011 SHRUG Individual Workshop Registration Form
To register individuals by submitting payment via Check, Money Order, PO, or Credit Card
Attendee First Name:
Attendee Last Name:
Attendee Organization:
Attendee Title:
Attendee Address 1:
Attendee Address 2:
Attendee City:
Attendee State:
Attendee Zip:
Attendee Phone:
Attendee E-Mail:

Attendee Type:

Demographic Information Required for Early, Regular, Late and Student Registrations.
T-Shirt Size:
2002 Attendee?
2003 Attendee?
2004 Attendee?
2005 Attendee?
2006 Attendee?
2007 Attendee?
2008 Attendee?
Shruginar August, 2009?
Shruginar January, 2010?
2010 Attendee?
Shruginar March, 2011?
GIS Experience:

Years using GIS?
Receive Vendor Information?

Billing First Name:
Billing Last Name:
Billing Address 1:
Billing Address 2:
Billing City:
Billing State:
Billing Zip:
Billing Phone:
Billing E-Mail:

Billing Credit Card Type:
Account Number:
Expiration Date:
VIN Number:

Mail To: SHRUG Inc.
Attn: Workshop Registration
PO Box 3887
Tallahassee, FL 32315-3887
For more information regarding Workshop registration please contact
Ana Nowak