University of Illinois

1999 Illinois Crop Protection Technology Conference Preregistration Form

November 6, 1998
UFAS ACCT# 1-3-64014-0660 FEIN# 37-6000511-Rev.'99 Crop Tech.

Conference Dates: January 6 and 7, 1999

Location: University of Illinois, Illini Union, Urbana, Illinois

Please mail completed preregistration form(s), or fax to (217)333-9561, by December 18, 1998. Call (217)333-2881 to register by phone. On-line registration is possible through the World Wide Web a (


Social Security #

Federal legislation may make it possible for participants in certain educational programs to qualify for lifelong-learning income tax credit(s). To receive a statement from the University of Illinois, you must provide your social security number. Providing this information is voluntary, and it will be used only for tax-reporting purposes.



City/State/Zip Code


Telephone (business)

Telephone (home)

Method of Payment

____Check enclosed (made payable to the University of Illinois)

____I prefer to charge on credit card:

VISA MasterCard
American ExpressDiscover
Card No.Card No.
Expiration DateExpiration Date

Signature of card holder:

Preregistration: $80 per person (includes one copy each of the 1999 Proceedings of the Crop Protection Technology Conference and the 1999 Illinois Agricultural Pest Management Handbook.) Walk-in registration is $95.

NOTE: If paying for more than one person, please enclose a completed preregistration form for each person (one check may be written to cover the total payment).

Mail completed preregistration form(s) along with payment to

University of Illinois at Urbana-Champaign

Cashiering Office

Administration Building Room 162

506 South Wright Street

Urbana, IL 61801

Author: Mike Gray