2007 VOLUNTEER WATER QUALITY MONITORING
LEVEL 1 WORKSHOP REGISTRATION FORM

***Due to the high demand and limited space for these classes, individuals under the
age of 18 need to be accompanied by a sponsoring adult in order to attend.

Location and Date of Level 1 Workshop you wish to attend: 

________________________________________________________________

Name:___________________________________________________________

Address: _______________________________________________________

City, State, Zip: ______________________________________________

Telephone Number: ______________________________________________

Are you a teacher? __Yes __No

STREAM TEAM / Organization/ School affiliation:
 ______________________________________________

Stream you are monitoring:
_____________________________________________________

County in which the stream is located: 
__________________________________________________

Description of the location on the stream where you would like to monitor
 (e.g. upstream from Highway 70 bridge):

________________________________________________________________

USGS Topographic Quadrangles) for your site(s):
_________________________________________________________________

Return to:
PRISCILLA STOTTS
Water Protection Program
MISSOURI DEPARTMENT OF NATURAL RESOURCES
P.O. BOX 176
JEFFERSON CITY, MO 65102-0176