Participant Information

Name

Affiliation

Address

City

State

Zip

Primary Phone

E-mail

Summit Selections & Fees

Ag Summit

(Includes sessions and meals)

February 20-22

$90.00 (after 2/6/12, fee will increase to $125)

Please mark the provided meals which you will attend:

        All-Idaho Strolling Supper, 2/20

        Ag Leadership Breakfast, 2/22

        Governor's Awards Luncheon, 2/22

Single Day of Ag Summit (not including Shippers Workshop)

(Includes sessions and meals)

$50.00, Tuesday only (after 2/6/12, fee will increase to $60)

$50.00, Wednesday only (after 2/6/12, fee will increase to $60)

If attending just Wednesday, 2/22, please mark the provided meal(s) which you will attend:

        Ag Leadership Breakfast, 2/22

        Governor's Awards Luncheon, 2/22

Young Farmers/Ranchers

(under age 40)

$60.00 (after 2/6/12, fee will increase to $85)

Please mark the provided meals which you will attend:

        All-Idaho Strolling Supper, 2/20

        Ag Leadership Breakfast, 2/22

        Governor's Awards Luncheon, 2/22

If you have a guest(s) joining you for a meal or you can only attend a portion of the Summit, choose any of the following:

All Idaho Strolling Supper

February 20

  $40.00          How many?

Ag Leadership Breakfast

February 22

  $20.00          How many?

Governor's Awards Luncheon

February 22

  $40.00          How many?