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Institute for Curriculum and Campus Internationalization (ICCI)
ENROLL HERE ICCI Home Page

  20-23 May 2012  

Enrollment Closed

Sign up here for...

    

 ICCI Online Enrollment Form
 Sunday, May 20 – Wednesday, May 23, 2012

 Personal information 
  1. Full name:
First

Last

  1. Professional title, position, department, institution:

Title (Dr., Mr., Ms., other)

Department

Position

Institution

  1. Current professional contact address, e-mail, and telephone:
Current street address
Current city
Current state
(enter N/A if not applicable)


Current country

Current zipcode (5-digit)
Current e-mail
Current phone (xxx-xxx-xxxx)
  1. Contact information after April 30 (if different):
Street address
City
State
(enter N/A if not applicable)

Country

Zipcode (5-digit)
E-mail
Phone (xxx-xxx-xxxx)
  1. Dietary restrictions:
Textbox
  1. Other medical or personal concerns:
Textbox
  1. Where did you hear about ICCI?
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 Institute Options
  1. Select your desired ICCI focus: Course      Campus     
  1. Optional pre-conference workshop – Introduction to Internationalization in Higher Education. Cost: $50. 9am-noon on Sunday, May 20:
    will attend      will not attend
  1. Required – IU Bloomington "A" parking pass. Please indicate if you already have a valid IU "A"parking pass.  If not, please indicate whether you will need one or not.
    have a valid "A" parking pass      will need a valid "A" parking pass      will not need a parking pass
  1. Accommodations – participant’s responsibility. Please indicate if you would like to:
    reserve a low cost room on campus in the Willkie Residence Center – $49.40 + 12% / night (paid at Willkie check-in). If you have questions concerning the facilities and amenities at Willkie, please contact the Willkie front desk (812) 856-4804.
    arrange your own accommodations – see Where to Stay.
  1. Other information that you would like us to know about:
Textbox
  1. You will be e-mailed a link to our ICCI Participant’s Web site for more information.  If you have questions, you can always contact us at icci@indiana.edu.
  1. The enrollment fee* is $300. Cancellations must be made in writing to iuconfs@indiana.edu no later than April 30, 2012, to be eligible for a refund, less a $50 administrative fee. No refunds will be issued after April 30.
    *The enrollment fee includes two books and all food except one dinner.
 Application Complete
  1. By pressing the "submit" button below, your enrollment information will be saved and you will be given the link to the IU Conference page where you will make your online payment.

 
 
Indiana University is an equal opportunity/affirmative action institution. If you have a disability and need assistance, special arrangements can be made to accommodate most needs. Center for the Study of Global Change
201 N. Indiana Ave., Bloomington, IN 47408-4001
Phone: (812) 856-5523    Fax: (812) 855-6271    E-mail: global@indiana.edu
This page page was last modified on: 05/8/12
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