irrigation01.gif (10787 bytes) Irrigation Management Home Study Course
General

Use this registration form if you do not desire CCA Credits, but want to take the Course.

UNL Irrigation Home Study Registration Form -- Please print and attach check

*First Name: *Last Name: 

*Mailing address: 

*City: *State: *ZIP: 

Phone: Fax : 

Email: 

*Number of courses needed: ($60 per course)

*Total Amount Enclosed: $ (Check payable to UNL Extension)

new4a.gif (2109 bytes)Yes, I would like to take the quizzes on the Internet and receive instant feedback to my answers. Please send me a user ID and password for the Internet version.  (If you check this option make sure and include your e-mail address above). 

*Required fields for registration form


Return this form and a check to: Phelps County Extension
Attn: Chuck Burr, Extension Educator
1308 Second Street, Holdrege, NE  68949
Fax: 308-995-8581
  Phone: 308-995-4222
  Email: cburr@unlnotes.unl.edu  
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