Registration Form Special Course"People and Gopher Tortoises, at Home and in Citrus County"
Name____________________________________________________
Adress___________________________________________________
__________________________________ Zip ______________
E-mail____________________________________________________
Affiliation__________________________________________________
I have enclosed $ 15.00 donation for the Program on May 20. ________
I have also included $ 35.00 for membership in GTCI. _______
Total amount _________
Send this form with enclosed payment to the adress below.
Ashton Biodiversity Research and Preservation Institute, Inc.
Gopher Tortoise Conservation Initiative
14260 - 331 W. Newberry Rd.
Newberry, FL 32669
Tortfarm@aol.com
352 - 495 - 7449 Phone
352 - 495 - 7433 Fax
EIN NO. 59-3613952 ABRPI sollicitation No. N9000005237
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