Registration Form                     Please Print & Mail to address below

Southwest Michigan Horticultural Days
February 4th & 5th, 2004

Name(s)_____________________________          _____________________________

              _____________________________          _____________________________

Address_____________________________________________

City____________________________State______ Zip___________________

Phone #______________________________________________

Hort Days Pre-registration $20 per person

Total Amount Enclosed $____________

Make checks payable to: Michigan Grape Society

Mail to: Van Buren MSUE, Atten: Jerri Pursley
801 Hazen St., Suite A,
Paw Paw, MI 49079

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