NON-DOI PERSONNEL REGISRATION FORM

Safety Evaluation of Existing Dams (SEED) Seminar
May 11-15, 2015

Please complete and submit this form by April 9, 2015


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

 

Name:  _________________________________________________________________________


Position or Title:  ____________________________________________________________
(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:


________  Engineering Geology and Dam Safety


________  Evaluation of Seepage, Uplift, and Piping Concerns


________  Emergency Management Tabletop Exercise


Please indicate (circle) if you plan to attend the field trip planned for
Wednesday 5/13/2015:  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