Please fill out one form per person attending the school.
2009 Steam School Registration Form
Name
Name on Badge
Name on Certificate
Street Address
City State AL AK AZ AR CA Canada CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip
E-mail Phone No.
E-mail will be sent to confirm registration
Number of years operating engines
What do you expect to get out of this class?
Do you plan on camping? Yes No
Do you plan on having the Saturday night catered meal (optional) for $10.00? Yes No
Please make checks payable to the Wisconsin Historical Steam Engine Association Inc. (WHSEA)
Forward your $50 class fee, meal money, if applicable, and registration form to:
Jeff Bloemers
W4597 County Rd. F
Waldo, WI 53093
Copyright © 2009