WASCOE Convention Registration Form

Name:  __________________________________________________________________

County Office: ____________________________________________________________

Number Attending Convention _______________________________________________

Registration Fee:  $5 per person X __________    = __________________

Number Attending Banquet:  _________ X $18.00 = _________________

TOTAL AMOUNT DUE = $______________

Make Checks Payable to WASCOE

Mail to:       Mary Behm

                  Dunn County FSA Office

                  390 Red Cedar St.

                  Menomonie, WI 54751-2265

Phone:        (715) 232-2614

FAX:          (715) 232-1542 

 Please fax me a map!! ___________

EVERYONE IS WELCOME!!!  SEE YOU THERE!!!