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Environmental Health Administration
District of Columbia Watershed Protection

District of Columbia
Department of Health Erosion Control and Storm Water Management Workshop and Trade Show
Registration Form

Please fill out the enclosed registration form online, print and mail the completed registration form (with payment) to the address below. This form is for conference registration only and does not include lodging. Please contact the Days Inn Connecticut Avenue directly for room reservations (see “Hotel Accommodations” below).

Registration includes entrance to all on and off-site sessions including plenary session, breakout sessions, 2 continental breakfasts, 2 lunches
and all refreshment breaks, transportation to the field trip (SWM BMP tour), as well as all registration materials.

Name:
Title:
Organization:
Mailing Address:
City/State/Zip:
Telephone: Fax:
E-mail:
Please indicate if you require vegetarian meals:Yes No
Please indicate if you will be attending: Field Trip: Yes   No

Registration Fee:
Non-MAC/IECA Members: $75
MAC/IECA Members $50

Check or money order made payable to: MAC/IECA

Print Form and Mail to:
Attn: Melinda Church
DC Department of Health
Watershed Protection Division
51 N Street NE, 5th Floor
Washington, DC 20002
(202) 535-2977
(202) 535-1364 - Fax

Conference Registration should be postmarked on or before April 16, 2004
Hotel Accommodations