Cooperative
Extension
Service


University of Illinois
at
Urbana-Champaign


No. 24/November 7, 1997

1998 Illinois Agricultural Pesticides Conference

1998 Illinois Agricultural Pesticides Conference
Preregistration Form
UFAS 1-3-63895-0660

Conference dates: January 6, 7, and 8, 1998
Location: University of Illinois, Illini Union, Urbana, Illinois
Please mail completed preregistration form(s), or fax to (217)333-9561 by December 19, 1997.

Name

Company/business

Address


City/state/zip


Telephone (business)
(home)


Method of payment:

_____ Check enclosed (make checks payable to the University of Illinois)

_____ I prefer to charge on credit card:

Visa _____ MasterCard _____

Card no. Expiration date

Signature of card holder

Preregistration: $75 per person (includes one copy each of the 1998 Conference Proceedings and the 1998 Illinois Agricultural Pest Management Handbook). Walk-in registration fee is $90.

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

Mail completed preregistration form(s) along with payment to

University of Illinois at Urbana-Champaign
Accounting Business Office
Administration Building Room 162
506 South Wright Street
Urbana, IL 61801