b'Spose..T ,. Registration FormCEorm 1Registration~ Because space is limited for Optional Activities, you will want lo sign up in advance to assure a place is held for you.Sunday, October 7, 1990 Please indicate in the space provided below, the Optional Activity you wish to attend Tuesday, October 9, 1990.7 a.m. - 8 a.m.CERTA Registration NOTE:Please attach a sheet with names of8 a.m. - 3 p.m.CERT A Program additional registrants, if necessary.The program will include inslruction for torch welding applicators in safe working practices, torch Name ______________________welding equipment, application methods and procedures, and vapor and liquid propane technology.Passing a proficiency test at the end of _Company___________________the daywillresult in MRCA Certification.Lunch willbeprovided. Company Phone~-~______ _2 p.m. - 7 p.m.Trade Show Opens Address City ________Zip____ State_Name ________,INDICATE OPTIONALAddress ACTIVITYYOU WISHCityState ___ Zip TO ATTEND:Phone~,_) ______________ _Optional Activities are included as part of Full Registration Package. Company __________________Company Phone(____)________ DGruene, Texas Tour_ _Address ______ $40 fee for "Trade Show ONLY" registrants City. ____ State _______ Zip OR Registration -To register for the CERTA Program, send in this form with your payment.The registration fee is $65 per person which 0Brunch on the River & Tourincludes lunch, course materials and a visitlothe Sunday $45 fee for "Trade Show ONLY" registrantsevening Trade Show.Register by October I, as spaceis limited.Applications will be taken on a first-come, first-serve basis. Amount$Amount$ 0Check Enclosed0Check Enclosed Made payable lo Midwest Roofing Conuactors Association.Made payabl~ io Midwest Roofing Contractors Association. 0MasterCard0MasterCard 0Visa0Visa 0American Express0American Express Account#Account#__________________ _Exp. Date ___!___Exp. Date ____/___ __Signature __Signature ______________ _'