V Online: Go to to Sign Up( Credit Cards Via Paypal)

HOW TO REGISTER

You may register by:

v  Online: Go to www.ebsbiowizard.com/wastewater-treatment-seminar/registration to sign up( Credit cards via PayPal).

v  Mail: Print registration form and mail to:

Environmental Business Specialists, P.O. Box 1936, Mandeville, LA 70470-1936

v  Email: Send completed registration form to

v  Fax: 985-674-3483

ATTENDEE INFORMATION & REGISTRATION

Attendee 1 / Attendee 2 / Attendee 3
Name
Company
Position or Title
Business Address
City /State/Zip
Business Phone
Business Fax
Email
System type
Registration / $750 / $750 / $750
10% Discount if you register before April 15th * / -$75/reg
Total registration charges

*Contact for group rates

PAYMENT INFORMATION

 Personal check

 Company check

 Attached Purchase Order or PO number ______

 Credit card: Visa, Master Card, American Express (Include name on card, type of card, number, expiration date, 3 or 4-digit security code on back of card, and address & zip associated with the card) ______

Payment or PO must be received in order to guarantee registration. Please make check or PO payable to:

Environmental Business Specialists, LLC

P.O. Box 1936

Mandeville, LA 70470-1936

Special Diet Requests:

For more information, contact Marie Tranchina at 985-674-0660x114 or email .

All samples should be shipped to: 1930 Surgi Dr, Mandeville, LA 70448