Register for the 2009 GLRPPR / Region 7 Conference in Indianapolis, IN

June 3-5, 2009
Eiteljorg Museum of American Indians and Western Art
Indianapolis, IN

Payment:

Check, cash, or credit cards will be accepted as payment in advance. Only check and cash will be accepted at the door. If paying by check or cash, you will receive an invoice stating the total price that you owe after submitting this form. To ensure a smooth registration, it is recommended that you pay in advance. Register by making checks payable to the University of Illinois and mailing your payment to:

GLRPPR Conference
c/o Wayne Duke
Illinois Sustainable Technology Center
1 Hazelwood Dr
Champaign, IL 61820

U of I's FEIN Number: 37-6000511

Please note that the registration fee does not include hotel costs. You have to make your own travel and hotel arrangements. There is a block of rooms set aside at the
Comfort Suites City Centre
515 S West St
Indianapolis, IN 46225
Phone: (317) 631-9000
Fax: (317) 631-9999
Block: Government rate of $94.00/day and $10.00/day parking

Refunds:

The cut off date for cancellations and registration refunds is May 25, 2009. If you do not notify us by May 25th of your cancellation, a refund will not be processed and you will be invoiced for any unpaid registration fees.

Please fill out the form below and press "Submit" to pre-register for the conference. Your registration will be complete upon receipt of full payment.

First Name*
Last Name*
E-mail*
Affiliation / Org.
Address*
Address 2
City*
State / Province*
Zip*
Telephone*
* = Required

Days Attending:

Meal Selection

Please choose which meals you would like on the days you are attending.

Meal options are:

Smoked turkey with White cheddar on Wheat Baguette
Ham and Swiss cheese on Rye bread
Roast beef with Monterey Jack cheese on White Baguette
Silver City Caesar
Grilled Chicken, Romaine, Red Chili Croutons and Shaved Manchego Cheese Tossed with a Cilantro Caesar Dressing.
Cactus Cobb
Mixed Greens, Turkey, Bacon, Blue Cheese and Pico De Gallo Tossed with a Blue Cheese Ranch
The Phoenix
Field Greens with Roasted Turkey, Dried Cranberry Chutney, Grilled Onions Anchiote and Smoked Gouda Cheese with a Roasted Yellow Pepper Vinaigrette.
None
Choose this option if you do not need a lunch for this day.

Wednesday (6/3)	Thursday (6/4)	Friday (6/5)

Payment Method:

If you have any questions or special needs, please tell us in the text box below:

Contact Information:

Bob Iverson
Great Lakes Regional Pollution Prevention Roundtable
1 Hazelwood Dr
Champaign, IL 61820
biverson@istc.illinois.edu

(For questions regarding registration)
Wayne Duke
Great Lakes Regional Pollution Prevention Roundtable
1 Hazelwood Dr
Champaign, IL 61820
wduke@istc.illinois.edu

		Great Lakes Regional Pollution Prevention Roundtable Promoting Pollution Prevention Through Information Exchange