Explosion Effects and Structural Design for Blast
Two-Day Training Course

Drury Inn & Suites Riverwalk, San Antonio, TX
March 8 and 9, 2011

Registration Form
Fax this completed application to: FAX No. (573) 882-4784

then mail the registration fee payment to the address below:
Or mail the application with the payment to:
Dr. Sam Kiger, PE
1213 Dunbar Drive
Columbia, MO 65203

First Name

Last Name

Professional Title

Company

Address

City

State

Zip Code

Phone

( ) -

Fax

( ) -

E-mail

Payment Information

Registration Fee: $995.00 per person
If registering via mail:
Mail printed application and a check (only checks are accepted via faxed/mailed applications) for the amount of $995.00, made out to Dr. Sam Kiger, to the following address.
If registering via fax:
Fax printed application to 573-882-4784 and mail a check (only checks are accepted via faxed/mailed applications) for the amount of $995.00, made out to Dr. Sam Kiger, to the following address.
Dr. Sam Kiger, PE
1213 Dunbar Drive
Columbia, MO 65203

Comments/Questions: