Module:     Freshwater Wetlands     /     Coastal Systems    /     Upland Habitats

Instructor Code/s:
County:

Organization: 
Training Facility Name:
Building Name or Number:
Facility Room Number:
Address: 
City: 
State: 
Zip: 
Phone: 
Fax: 
Email:
Web Site:

Course Instructors (names & titles): 

Course Assistants (names & titles): 


Course Schedule:
List in following format:

• date/day/times/comments (Field trip, special items, etc.) [one session per line.]
• sample:
     July 2, 2001/Monday/5:00pm-6:30pm/Classroom, Video, Presentations
      July 3, 2001/Tuesday/5:00pm-6:30pm/Classroom, Video, Presentations
      July 7, 2001/Saturday/9:00am-12:30pm/Marsh field trip, outdoor

Instructions:

1. Please complete the form. All training sites must be on file with the FMNP Conference Coordinator.

2. Each class is limited to 20 students.  You can set a maximum number below 20. All registration is in advance (No on-site registration allowed).

3. Instructors are responsible for local publicity of their training courses.

4. Instructors must fill out the Student Record Form and mail it along with any unused patches, pins &  workbooks, signed liability forms and completed evaluations to the FMNP Conference Coordinator (Shelby Sowder). Once received, the Incentive check will be processed.

5. A master file will be kept with the Instructor's approved affiliated organization and incentive payment information.  Incentive checks will be made out to the Instructor's affiliated organization and mailed to the fiscal person.

For Registration Information:
Shelby Sowder, Conference Coordinator
Office of Conferences and Institutes (OCI)
University of Florida Leadership and Education Foundation, Inc. (UFLEF)
Institute of Food and Agricultural Sciences (IFAS)
PO Box 110750
Building 639, Mowry Road
Gainesville, FL 32611-0750
PHONE: 352-392-5930 / FAX: 352-392-9734
EMAIL: msowder@ifas.ufl.edu

For Program Information:
Ginger Allen, FMNP Coordinator
Phone: 239-658-3409
Fax: 239-658-3469
Email: info@masternaturalist.org

If you see a "FORM CONFIRMATION" after clicking the "SEND COURSE BOOKING" button, your form has been properly transmitted.

Please print a copy of the "Form Confirmation" and keep for your records.

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