Registration - Midwest Community Development Institute

Registration

Name for Badge
Name
Organization/Business
Title
Email
Address
City
State
Zip
Daytime Telephone
Fax
Please specify any dietary or special needs
I will be participating in Year 1
I will be participating in Year 2
I will be participating in Year 3
If you are interested in sharing a hotel room or have any special needs, please contact us.
"Early Bird" Registration
$50 Deposit (The additional $450 must be paid by July 4, 2008)
$500 Full Amount
Note: After July 4, 2008, the cost for registration will be $550.
Please send deposit or payment to: Sandy Wittig Illinois Institute for Rural Affairs Western Illinois University 1 University Circle Macomb, IL 61455-1390 309.298.2237 800.526.9943 (Checks need to be made payable to the "Illinois Institute for Rural Affairs." The WIU FEIN number is 37-0910458.)

   Questions?
   info@midwestcdi.org
   (309)298-2237