VIRGINIA AGRICULTURE SUMMIT

Registration Form

You must pre-register to attend.

Early bird fees apply on or before January 30, 2009.

Name:

Address:

City:

State:

Zip Code:

Daytime Phone:

E-mail Address:

Special Needs:	If you have special needs, call 804-290-1155.

Meals:	Please indicate which meals you plan to attend: Lunch February 9 Yes, I will attend. No, I will not attend. Lunch February 10 Yes, I will attend. No, I will not attend.

Reception:	A reception will be held Monday, February 9 Yes, I will attend. No, I will not attend.

Lodging:	Richmond Omni Hotel 100 South 12th Street Richmond, VA 23219 Room Rates: Special room rate of $123 per night, plus tax, if reserved by January 14, 2009. For reservations, please call 1-800-843-6664 or 804-344-7000. Reference the Virginia Ag Summit to receive a special rate. Parking Rates: $15 per day For more information or assistance please call Brenda Fleming at 1-804-290-1153.

Registration Fee:	Registration includes two lunches, breaks, continental breakfast and all sessions. Early-bird rate: $50 After January 30: $75 Please note: You must register by Jan. 30, 2009, to qualify for the early-bird rate.

Payment Options:	Credit Card (pay by phone) Check