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Exhibit/Poster Registration Form

Only for exhibitors and poster presenters, not necessary for attendees.
Please submit this form by March 22, 2013. If you have any questions about this form or registration, please contact Linda Lee Blaine at LL-Blaine@wiu.edu.

There is no fee to register or to have an exhibit.

Contact Information
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Exhibit Information
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Names of Exhibitor(s) (up to four)


Academic Poster Information
I will present/bring a:
Equipment Needed
Number of Tables Requested (check one):
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Do you need electricity?
Free Wi-Fi will be available.
Student Sustainability Awards
Career/Internship Opportunities
Questions or Comments

For more information, contact:

Mindy Pheiffer, Program Coordinator
Horn Field Campus
Western Illinois University
Phone: (309) 833-5798
Fax: (309) 837-4676
Email: MJ-Pheiffer@wiu.edu

For registration questions, contact:

Linda Lee Blaine
IIRA
Western Illinois University
Phone: (309) 298-2647
Fax: (309) 298-2142
E-mail: LL-Blaine@wiu.edu