Minnesota Soybean Growers Association

REGISTRATION FORM
2010 International Marketing Mission
New Orleans/Atlanta Trip
January 25 - 29, 2010
First Name :
Middle Initial :
Last Name :

(As it appears on your driver's license)
Street Address :
City :
State :
Zip Code :
Gender : Male Female
Date of Birth (DD/MM/YY):
Daytime Phone :
Evening Phone :
Email :
Verify Email :
Fax : (Optional)
Airport Departing From :
Seating Preference :
(Seating preference not guaranteed)		 Window Aisle
   
Emergency Contact  
Emergency Contact Name :
Relationship to Traveler :
Emergency Contact Phone# :
   
Other Air Travel Needs?  
Will you require a hotel room in Minneapolis the night before departure?
You are eligible if your drive to Minneapolis is 2 hours or more,
or if you have to leave your home before 6:30 a.m		 Yes No
   
Will your spouse be attending?
(Please note that spouse can only be added at time of registration -
complete separate registration for spouse)

 

(You will be contacted for payment arrangements for spouse's travel costs)		 Yes No
   
Miscellaneous  
Questions & Comments :
   
 
For travel related questions after you have completed the online registration call toll-free 1-866-448-7055
  
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