Organic Intensives Registration Form

*Must complete a separate registration for each attendee.

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Name & Email of Attendee if Different From Above

I am a...

Select Your Track

Select Your Registration Type

Round Trip Bus Transportation From and To Detroit (Exact location TBD. Bus will depart Detroit at 7 AM and return at 6:15 PM.)

No, I do not require round trip bus transportation from Detroit.
Yes, I would like to reserve a seat for round trip bus transportation from Detroit.

Your Type &

Would you like to be added to our newsletter list?

Total

$0.00

Payment Method

Card Number

Expiration Date

Security Code

Card Holder Name