Registration

Personal Information

Please complete the Personal Information form in order to register for the IIT Educational Conference held on April 31th, May 1st and May 2nd. The cost of the conference is as follows:

There is no charge for students or speakers attending the Conference.

Please note that all fields that are required are marked with ' * ' symbol.

First Name*
Last Name*
Title
Tag Name
Institution or Company
Phone*
E-mail*
I plan to attend*: May 1st
May 2nd
I am a: *

I have dietary restrictions.
Please explain:

I require special assistance.
Please explain:

Payment Options

Please complete the above form in order to register for the IIT Educational Conference. If you prefer to pay the fee for attending this Educational Conference by credit or debit card, please proceed to payment.

If you prefer to mail your check payment to us, please use the follow address and make the Payee, Illinois Institute of Technology. Payment must be received by the start of the Conference.

Interprofessional Projects Program [IPRO]
IGT - 4th Floor, Room 4A5-1
3424 S. State Street
Chicago, IL, 60616

Fax: 312.567.3950