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Registration Form

Please complete the form and mail in your payment to the address below. If you would like to pay by credit card (Visa or MasterCard) please call 559.278.2352. The deadline to register is June 1^st, 2012.
The information on this form will be used to generate name badges.

Choose which program you plan to attend:		First Year Program
		Second Year Program
	To enroll in the Second Year Program, registrants must have completed the First Year Program

First Name
Last Name
Position
Organization
Mailing Address
City
State
Zip
Daytime Telephone
E-mail
Special Dietary Needs:

Please make check payable to:	Ag Lenders Society of California

Please send payment to:	Ag Lending Institute University Business Center California State University, Fresno 5245 N. Backer Ave, M/S PB5 Fresno, CA 93740-8001
	Phone:	559-278-2352
	Fax:	559-278-6964

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