Registration form

Louisiana Farmers Market Conference
WEDNESDAY, SEPTEMBER 7TH 2011
(Location: Chef Roy’s Frog City Cafe, Rayne, La)
Registration Form
(Please fill out one form per person)
Name _________________________________________
Farmers market___________________________________________________________
Farm business (if applicable) _________________________________
Address ______________________________________________
City, State, Zip Code _________________________________________
Contact information: Phone _______________Email: _____________________________
(An e-mail address or telephone number will be used to send any updates)
Do you need a vegetarian lunch option (circle)? YES NO
Return the completed registration form to:
Amy Blanchard, LSU AgCenter School of Plant, Environmental and Soil Sciences 155 J C Miller Hall Baton Rouge, LA 70803 FAX: 225 578 1068 ablanchard@agcenter.lsu.edu