Gill Symposium Registration Form
Registering for the symposium is free, but attendees must cover the cost of parking.
Please fill out an individual form for each person registering for this event.
Nametags will reflect name as entered below.
**Every Field in this form is required.
(first, last name)
Please select one
IU School of Medicine
If Other, please specify: (up to 20 char.)
Will you attend the provided breakfast?
Will you attend the provided lunch?
Will you attend the reception?
Please insert the same letters (case-sensitive) and numbers you see in the image below.
This step has been taken to assure authenticity of the registration.
About the Gills
College of Arts & Sciences
The Gill Center
The Gill Center | MSBII | 702 N. Walnut Grove Avenue | Bloomington, IN 47405 | Phone: 812-856-1930 | Fax: 812-856-7187 |
2013, The Trustees of
| Last Updated: 09 April 2013