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The Seven Hills Regional User Group for GIS
2012 SHRUG GIS Workshop
"GIS Life"
2012 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:
Early Registration - $90.00
Student Registration - $50.00
Demographic Information Required for Early, Regular, Late and Student Registrations.
T-Shirt Size:
S
M
L
XL
XXL
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:
Newbie: This is all new to me
Geek: I have GIS experience
Guru: People ask me for help
Years using GIS?
Presenting?
Yes
No
Receive Vendor Information?
Yes
No
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:
VISA
MC
AMEX
PO
Vendor
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