OSU Extension Site Registration

2006 Program Dates (Check all that you will be hosting)
  Program 1 - January 18
  Program 2 - February 21
   
   
Times
The satellite program on January 18 will be scheduled from 6 until 7:30 pm.  The February 21st program will be from 7 until 9 pm.  Topics prior to or after the program are encouraged to meet local needs.

Your local start time and end time for each program are
Program 1:
Start:    End:
Program 2:
Start:    End:
   
   

Location for Viewing Program 1 (if the same for all just enter information for once)
Location name:
Street Address:
City:
Zip:
   

Location for Viewing Program 2 (if different)
Location name:
Street Address:
City:
Zip:
   

Location for Viewing Program 3 (if different)
Location name:
Street Address:
City:
Zip:
   
Registration Fee:
Pre-registration Required:
PAT Credits Offered:
   

Contact Information for Host and Pre-registration
Name:
County:
Address:
City:
State:
Zip Code:
Phone Number:
Email: