Georgia Chapter of the SWCS [home]

 

Member Card Survey

 

Please help us update our mailing list and plan future Chapter activities. 

 

NAME:  ______________________________________________________________________

ADDRESS: ______________________________________________________________________

CITY:  _______________________  STATE: ____  ZIP ________

EMAIL:  _______________________________________

PREFERRED PHONE NO(s): ______________________

This number is:  ____ Work     _____Home    _____ Other

I would prefer to receive information from the Georgia Chapter of SWCS via: ______ email OR ______ the U.S. Postal Service

I am interested in:       

______  serving on a Chapter committee

______  attending an educational workshop or conference

______  helping to plan a workshop or conference 

______  attending a family-oriented field trip or activity

______  attending a professional networking activity/outing

______  nominating someone for an SWCS award

______  (please specify)________________________________________________________________

Other comments?________________________________________________________

 

Please complete the requested information and mail to: 

Georgia Chapter of SWCS, c/o Dory Franklin, 1420 Experiment Station Road, Watkinsville, GA 30677

Or email to: dory.franklin@ars.usda.gov

Thank you!