Midwest Natural Resources Group

MNRG Annual Meeting 2004:
Registration Form

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November 17-18 , 2004
Radisson Hotel Schaumburg

Name: _____________________________________________________

Organization: ______________________________________________

Title: ______________________________________________________

E-Mail: ____________________________________________________

Phone: ____________________________________________________

Fax: _______________________________________________________

Address: ___________________________________________________

Dates you will be attending and registration fees:

10/17 & 10/18 ($55) _____ 10/18 Only ($20) _____

NOTE : Registration fees will be paid at the registration desk on the day of the meeting by cash only

If you are attending the dinner on Wed. Nov. 17, what entrée do you prefer: chicken, beef, or vegetarian? _____________________

Please return this registration form to the BLM in one of the following formats by Wednesday, Nov. 10, 2004 :

  1. E-Mail to: kurt_wadzinski@blm.gov
  2. Fax to: (414) 297-4405
  3. Mail to: BLM Milwaukee Field Office
    626 E. Wisconsin Ave.
    Suite 200
    Milwaukee , WI 53202-4617

Reminder : Please contact Radisson hotel directly at (800) 333-3333 for room reservations by Wednesday, Nov. 10, 2004 . Please reference MNRG Annual Meeting when making reservations.

August 25, 2006