| Please return by November 15, 2006, with registration fee. | |
| Name(s):____________________________ | |
| Adress:_____________________________ | |
| City:_______________________________ | |
| Zip:________________________________ | |
| Phone:______________________________ | |
| *Email:______________________________ * e-mail addresses will only be used for class purposes and not given to anyone else | |
| Location I plan to attend | |
| _____ Columbia | _____ Glasgow |
| _____ Sedalia | |
| Class Fee $60/individual $75/couple | |
| If the class fee presents a significant financial barrier to your participation please contact Mary Sobba (573) 581-3231 or e-mail: sobbam@missouri.edu | |
| Make Check Payable to: | University Extension |
| For all locations, return this form, with payment to | |
| Audrain Extension Center |
| 101 N. Jefferson St., Rm 304 |
| Mexico, MO 65265 |