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Please complete the following online registration form by May 1, 2010 if you plan to attend the 2010 State Politics Conference in Springfield, Illinois. There is no registration fee. Advanced registration will help us plan for the number of attendees, order meals, and prepare conference materials in advance.
Are you experiencing difficulty with this form? You may contact the webmaster from
this link
.
First Name:
Last Name:
Email:
Username:
Password:
Verify Password:
When will you be arriving in Springfield?:
Thursday Before Evening Reception
Thursday After Evening Reception
Friday Morning
Friday Afternoon
Saturday Morning
Are you planning to stay in the Conference Hotel?:
Yes - if so, please book by March 1, 2010 to ensure conference rate.
no
undecided
Your Institution:
Address:
City:
State:
Zip Code:
Country:
Phone #:
RSVP Thursday Evening Reception:
Yes - I am Attending
No - I am Not Attending
RSVP Friday Evening Banquet:
Yes - I am Attending
No - I am Not Attending
Do you have any special dietary needs?:
No
Yes, I'd prefer vegetarian meal options.
Yes, other; please briefly explain:
Please briefly explain any other dietary needs.:
Any additional comments or special needs we should be aware of?:
Are you experiencing difficulty with this form? You may contact the webmaster from
this link
.
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