Computers on the Farm
Missouri Farm Computer Users Conference


Mail In Registration Form


* indicates required information
 
*First Name:
*Last Name:
*Home Address:
*City:
*State:
*Zip:
*Daytime Telephone:  (Format xxx-xxx-xxxx)
Business Name:
Business Address:
City:
State:
Zip:
E-mail Address:
Make of Computer:
Please reserve a vendor table for my company: YesNo
 
*Registration Fee: (Select the number of registrants that you need in each box)
 
Primary Registrant(s):
  Through January 8, 2018 - $125.00
  After January 8, 2018 - $135.00
 
Additional Company or Family Member(s):
  Through January 8, 2018 - $95.00
  After January 8, 2018 - $105.00
 
Name and address of additional registrant(s):
(Hit enter after each additional registrant's name and address)
 
Computing issues I need help with: 
 
Do you have special arrangements for meals or facilities? If so, explain: 
 
Method of Payment:
Credit Card
Payment Enclosed (Checks only)
Bill my organization
 
 
  

Other Registration Options
 
By Phone
Phone in registration information to AgEBB at 573-882-4827.