Contact Information
Name (first, middle initial, last )

Department and Institution

Building and Room Number

Home Address - Street, City, State, Zip

email

SS#
Date of BirthDegree

PHONE (Day)(Evening)

Tuition $750
Two Ways to Save!

• Save $100 Early Bird Registration rate: $650
  Must Register by 8/16/05 or
• Significant Group Discounts (3 or more)
  contact Mark Nardone 301-496-8290

Tuition Enclosed $______
Full tuition must accompany registration form.

Payment Type :
Check - payable to FAES
Training Form
Credit Card: VISA MasterCard

Card#
Exp. Date

Authorized Signature_____________________________

The FAES does not discriminate on the basis of race, color, religion, sex, age, handicap, national or ethnic origin or veteran status, in administration of its educational policies, admissions policies, scholarship programs, and other educational programs. FAES: 301-496-2316

In order to keep workshop cost (and your fees) to a minimum, all participants must make their reservations through the Resort's Reservation Department by calling 1-800-233-1234. Please reference the "FAES" meeting to receive the negotiated discounted rate of $127 per night plus taxes.

*Program Fees do not include Lodging or Meals

Academic Credit: Although no grades are given for BIO-TRAC courses, a registrant completing a lecture/laboratory course will earn one credit. Upon completion of each TRAC, a certificate is issued to each participant.

CREDIT CARD REGISTRATIONS can be faxed directly to FAES: 301-402-0174