AEC Registration Form
(If you don't have Acrobat Reader, download it here FREE.)

Please register using our PDF form above, or if you can not download Acrobat, you may print this web page and send to:
MACC, 10 Juniper Rd., Belmont, MA 02478)

NAME:
COMMISSION/ORGANIZATION:
E-MAIL ADDRESS:
STREET:
CITY/STATE/ZIP:
PHONE: (W) (H)
MACC Members $85* • Other Government & Nonprofit employees $95** (when fee is paid by agency) • Non-members $110*** (Fee covers refreshments, lunch and workshops) WALK-INS $10.00 MORE Mail form with check made payable to MACC, 10 Juniper Rd., Belmont, MA 02478. Call 617-489-3930 for more information. TOTAL ENCLOSED $:
* Member fee applies to: Conservation Commissioners and staff when Commission's dues are paid or accompany this registration; and other MACC members. ** Other municipal officials and government agency or nonprofit organization employees when fee is paid by agency or organization check. *** Nonmembers may receive member rate by joining MACC. Call for details: (617) 489-3930 Advance registration is recommended --payment must accompany the registration. Register early to guarantee your workshop choice--pre-register and number limits will be enforced. Refunds only if request received in writing by February 18, 2005. A $5.00 processing fee will be deducted from the refund. There will be confirmation of your registration IF your e-mail address is provided on this form.
TRAINING PROGRAM AND WORKSHOP CHOICES You may register for 1 or 2 Training Program Units, up to 4 workshops or a combination of Training Program Units and workshops. 617.489.3930 Because limited enrollment workshops fill quickly, a 2nd choice is required. Lunch is available from 11:15 a.m. to 2:30 p.m. in a separate building.
Fundamentals for Conservation Commissioners
9:45a.m. - 12:15p.m.	Unit 1 ___	OR	Unit 6 ___
1:15p.m. - 3:45p.m.	Unit 3 ___	OR	Unit 5 ___
Workshop Series
		1st choice	2nd choice
Series A (9:45 a.m.-11:00 a.m.) -- Workshop #
Series B (11:15 a.m.-12:30 a.m.) -- Workshop#
Series C (1:45 p.m.-3:00 p.m.) -- Workshop #
Series D (3:15 p.m.-4:30 p.m.) -- Workshop #

Register me for the full dayAdvanced Certificate Program 9:45 -4:15 (Leadership Core Day)  [      ]