You may print off the following and use as a registration form

Mexico Trip: _____________________, 2010

First Name:
Initial:
Last Name:
Home street address:
City:
State:
Employing Agency:_________________________________
Title:__________________
Business phone: (_______)_______-_____________
Home phone: (_______)_______-_____________
Last 4 digits of Social Security Number: ___ ___ ___ ___
Check enclosed for: $___________ (deposit required)

E-Mail:_______________________________________________________