Baystate Roads Homepage

WORKSHOP REGISTRATION FORM

Registration preference given to municipalities and EOT/ MassHighway employees. Unless space is available we will accept two registrations per municipality / organization.

Event/ Date/ Location/ Cost:	CANCELLED Storm Debris Cleanup, Lancaster, MA May 20, 2008 CANCELLED Chain Saw Skills/Safety, Belchertown, MA May 21-22, 2008 CANCELLED Storm Debris Cleanup, Belchertown, MA May 23, 2008 Pavement Preservation, Holyoke, MA May 21, 2008 - $50 per person Pavement Preservation, Sterling, MA May 22, 2008 - $50 per person Pavement Preservation, Taunton, MA May 28, 2008 - $50 per person Pavement Preservation, Tewksbury, MA May 29, 2008 - $50 per person MassHighway Safety Toolbox, Sterling, MA June 3, 2008 - $50 per person MassHighway Safety Toolbox, Northampton, MA June 5, 2008 - $50 per person MassHighway Safety Toolbox, Falmouth, MA June 17, 2008 - $50 per person FULL MassHighway Safety Toolbox, Marlborough, MA June 19, 2008 - $50 per person FULL NHI HMA Pavement Eval & Rehab, Sterling, MA June 11-13, 2008 - $125 per person
Name(s):		*You may register more than one person from the same agency by typing multiple names in this field.*
Agency:
Address:
City:	State:
ZIP Code:
Telephone:
Email:	(Needed for e-mail receipt of registration.)
Notes:		(optional, if you require an invoice, put that here.)

Please fill out this form completely and click submit. You may also send a check or money order with a copy of your registration, payable to University of Massachusetts, in the amount specified on the flyer to:

Chris Ahmadjian
Baystate Roads Program
University of Massachusetts
College of Engineering
214 Marston Hall
Amherst, MA 01003

Cash or check upon arrival is also acceptable. Please NO PURCHASE ORDERS. To avoid charges, cancellations must be received 3 days prior to the workshop. EOT/ MassHighway Employees will not be charged at the door to attend.
Call us if you have a special request at (413)545-5403.