Feed Manufacturing Short Course Registration Form

It is mandatory to fill out all required fields.

Name (required):

Title (required):

Company (required):

Company Address (required):

City (required): State/Province (required):

Zip/Postal Code (required):

Country of Residence (if outside USA):

Company Phone (required): Company Fax:

Email (required):

Alternative Email:

PLEASE CHECK YOUR EMAIL TO MAKE SURE IT IS CORRECT. After your
pre-registration is verified we will be emailing you important information about the meeting.

TRAVEL DOCUMENTS (if outside USA)

Passport Number (required):

US Visa (optional):

Nationality (required):

REGISTRATION INFORMATION

The cost of this course is US $450 per person if housed in double bedrooms, or US $550 if housed in individual hotel rooms. This includes lodging (May 17 and 18) and meals EXCEPT dinners. These fees DO NOT include air transportation to RDU Airport, health insurance, spending money and incidental expenses. You may pay by check, money order, or electronic transfer.

HOTEL ROOM

Double bedroom (a roommate will be randomly assigned to you). If you have the name of your roommate, please type his/her complete name here:

Total fee for the course US $450

Single bedroom: Queen or King size bed.
Total fee for the course US $550

FOOD ALLERGIES

Please indicate foods you ARE NOT able to eat due to food allergies:

Beef
Pork
Chicken
Fish
Shrimp
Eggs
Dairy Products

PHYSICAL LIMITATIONS

Do you have any physical limitations that we need to accommodate?

YOUR BACKGROUND IN FEED INDUSTRY OR FEED MILLING

Please give us a quick summary of your Feed Industry or Feed Milling background:

Do you have a degree in any area related to Animal Nutrition?

How much exposure have you had to the Feed Industry or Feed Milling?

What sectors of the Industry have you worked with?

Academy

Live Production

Breeders

Nutrition

Broilers

Processing

Extension

Purchasing/Sales/Marketing

Government

Turkeys

Hatcheries

Veterinary Services

Layers

Feed Manufacturing

(We would like to know the level of experience of each participant to try to guarantee a good course for everybody.)

CHOOSE YOUR METHOD OF PAYMENT

You may pay by check, money order, or electronic transfer.

Check
Money Order
Electronic Transfer

CONFIRMATION OF YOUR REGISTRATION

PLEASE  CONTACT EDGAR OVIEDO WITH YOUR METHOD OF PAYMENT. You will THEN receive an e-mail confirming your pre-registration from Lynn Strother (NCSUPOULTRYCOURSES@ncsu.edu). If you don’t receive this e-mail, please contact us by e-mail, phone or fax.

Cancellation Notice:
Prior to two weeks = No charge
Within last week = Half of enrollment fee
No show = Entire enrollment fee

Please mail your payment to:

Lynn Strother
Extension Poultry Science
NCSU, 229 Scott Hall
2711 Founders Drive
Campus Box 7608
Raleigh, NC 27695-7608

Phone: +1 (919) 515-2621
Fax: +1 (919) 515-7070

E-mail: NCSUPOULTRYCOURSES@ncsu.edu

For additional information contact:

Dr. Charles Stark
North Carolina State University
Cooperative Extension Service
Department of Poultry Science
229 Scott Hall
Raleigh, NC 27695-7608

Phone: +1 (919) 515-5399
Fax: +1 (919) 515-7070

E-mail: charles_stark@ncsu.edu

   

Was the information on this page helpful? Yes No