To register for the Thursday, June 5th One Northwestern task force presentation, cocktail reception and dinner, please fill out and submit the following form.

This event will be held at the Robert H. Lurie Medical Research Center on the Chicago Campus.

(See map at http://aquavite.northwestern.edu/maps/buildinglookup.cgi?lookupid=33).

Please note the deadline for online registration for the June 5th event is Thursday, May 29th. After this deadline, please call the Office of Administration and Planning at 847-491-4335 to register. Thank you.

Name:

Title:

Department(s):

Email:

Telephone:

Select Task Force: Select One Centers, Institutes and Departments Faculty Financial Models Graduate Education Integrated Enterprise Not on Task Force

Please indicate whether you will attend the presentation only or the presentation and reception/dinner: Select One Presentation only Presentation and Dinner

If you are staying for dinner, please select your dinner preference: Select One Beef Fish Vegetarian (Beet Tartlet) Not applicable

Parking vouchers will be available for the Huron-St. Clair Garage. Please indicate if you need will need a parking voucher: Select One Yes No

Please contact Jennie Rose Gibbs at 847-491-4335 if you have any questions regarding registration or have special dietary needs.