Registration Form
Safety Evaluation and Visual Inspection of Existing Dams
International Technical Seminar and Study Tour
September 15–25, 2008
Seminar and Study Tour Information
Please return this form by mail to the Bureau of Reclamation, International Affairs - Denver, P.O. Box 25007, Denver, CO 80225, or fax to (303) 445-6322.
Registration fee for seminar and study tour is $3800.
Name_______________________________________ Passport Number_______________________
Title or Position________________________________ Birthdate_____________________________
Agency/Organization_________________________________________________________________
Office Mailing Address_______________________________________________________________
City______________________________________ Country_________________________________
E-mail address___________________ Office Telephone _________________Fax_________________
Home Telephone (for emergencies) ______________________________________________________
HOTEL ROOM PREFERENCES: Arrival date _________________ Departure date______________
___Single___Double ___Smoking __ Non-smoking
If double, Roommate name_____________________________________________________________
Do you require any special services, i.e. dietary restrictions or accommodations for a disability or impairment? (Please explain your needs)
Optional tour of Rocky Mountain National Park on Saturday, September 20: _____ Yes _____No
PAYMENT METHOD: Please note -- Funding is not available from the Bureau of Reclamation. You must seek private sponsorship, if needed. Prepayment must be made by bank check, credit card, or wire transfer to address given below. Please indicate your payment method:
1. _____ Bank Check
2. Credit Card Number________________________________________
Name on the card ____________________________________ Expiration Date _______________
3. ______Wire transfer (If paying by wire transfer the seminar cost is US$3825). Please provide the following information to your bank)
1) Bank: Treasury NYC (Federal Reserve Bank)2) City: New York City, New York
3) ABA: 021030004 (Bank identifier)
4) ALC: 14060905 (Reclamation’s Account Number)
5) Reference: Bureau of Reclamation International SEVIED,
A1R-1465-8850-010-00-0-0 (9)