header
Home

Thank you for your registration for the
2012 Annual 507 Program Training. 

To pay by check or purchase order, please fill out the form below and send in with your payment.  All payment must be received prior to the conference.  Please note that there will be no refunds for registration fees.  Make checks payable to:  PRIZIM.  (No confirmations of paid fee will be sent.)  Print out this form, fill in the required information, and send the form and payment to:
 
Francie Boker
PRIZIM Inc.
The Granary
317 East Diamond Avenue
Olde Towne Gaithersburg, MD 20877
Fax: 301-840-0139
 
____________________________________________
Name
____________________________________________
Organization
 
Registration ($145)
 
Check off the following:
Pay by Purchase Order
Pay by Check:
        Check number __________
 

For information about registration payment, contact Francie Boker, PRIZIM Inc. at 301-840-2222, x167, fbroker@prizim-inc.com.  For questions about sessions or other conference questions, contact Joan B. Rogers, EPA Asbestos & Small Business Ombudsman at 202-564-6568, rogers.joanb@epa.gov or Angela Suber, EPA Asbestos & Small Business Ombudsman Team at 202-566-2827, suber.angela@epa.gov. 

Thank you!
 
For questions about the 2012 Annual 507 Program Training, contact:
Joan Rogers 202-564-6568
Angela Suber 202-566-2827
For questions about the conference web site, contact: 
Audrey Graylin Zelanko 724-452-4722