Illinois State Sport Management Symposium
Friday, February 24, 2012
Doubletree Hotel • 10 Brickyard Drive • Bloomington, Illinois 61701
*Registration will begin at 9 a.m. and panel #1 will begin at 10:15 a.m.*
Registration Form
Full Name: ________________________________________________________________________________
University/Organization:_____________________________________________________________________
Preferred Mailing Address:____________________________________________________________________
City: ____________________________ State/Province: ________________ Zip/Postal Code: _____________
Telephone: (______)__________________ Fax: (______)_______________
Email: ___________________________________________________________________________________
*Please provide a list of each individual’s name if you register as a group.*
CONFERENCE FEES
1. Registration Fees (Includes admission to symposium, internship fair & lunch)
POSTMARKED & PAID
PLEASE CHECK APPROPRIATE REGISTRAION FEE: BEFORE/ON FEB 10, 2012 AFTER FEB 10, 2012
Individual $25 $30
Group of 5 $100 $125
TOTAL ENCLOSED: $ __________
LUNCH PREFERENCES/ SPECIAL NEEDS
Vegetarian Option:
Special Dietary Needs/ Food Allergies: ____________________________________________________________________________
Please list any ADA Special Needs: _________________________________________________________________________
PAYMENT METHOD: Check or Money Order must be in U.S. funds payable to: ISU Dept. of KNR/ Sport Management. There will be
a $25.00 fee charged on checks returned by the bank due to insufficient funds. Registration confirmation/receipt and further information will
be e-mailed.
Please mail completed registration form with payment to:
ISU Sport Management Symposium
C/O Kelby Weiter
223 Redbird Arena
Campus Box 2660
Normal, Illinois 61790
For questions or more information please contact Kelby Weiter:
Phone: (502) 609-5340
Email: syskmweite@ilstu.edu
Cancellations and Refunds: Fees will be refunded fully if cancellation or change resulting in a refund is received via email or writing no
later than February 10, 2012. After that date, fees are non-refundable. All refunds will be processed after the symposium.