NON-DOI PERSONNEL REGISRATION FORM

Safety Evaluation of Existing Dams (SEED) Seminar
June 20-24, 2016

Please complete and submit this form by June 1, 2016


(Department of Interior (DOI) Employees must registration and
supervisor approval through DOILearn.)

 

Name:  _________________________________________________________________________


Position or Title:  ____________________________________________________________


Agency/Office/Organization:  ___________________________________________________
(Note: Attendance is limited to Federal, Tribal and Water Districts 
affliated with Reclamation Projects only.)  


Reclamation Area Office affiliation:  __________________________________________
(If you are with a District, please indicate the Reclamation Area Office you 
primarily work with)


Telephone:  ____________________________________________________________________


Mailing Address:  ______________________________________________________________


City, State, Zip Code:  ________________________________________________________


E-mail address (optional):  ____________________________________________________



Please indicate which one of the concurrent workshops you will attend in the 
afternoon on Thursday, June 23, 2016 (You may attend ONE workshop ONLY):


________  Engineering Geology and Dam Safety


________  Evaluation of Seepage, Uplift, and Piping Concerns for Dams


________  Emergency Management for Dam Safety Incidents


Please circle whether or not you plan to attend the field trip planned on
Wednesday 6/22/2016:  Yes  /  No


Mail the completed form to:					Or fax to:
          Bureau of Reclamation				Lisa Krest
          ATTN: Lisa Krest						303-445-6473
          P.O. Box 25007
          Mail Code 85-831300					or E-mail
          Denver, CO  80225					SEEDSeminar@usbr.gov