Affiliate Meeting Registration for 9/26/24

Registration form for IHEC Affiliate meeting.

Meeting will be held at: Concordia University Chicago

On: September 26, 2024

From: 9:00 AM to 3:30 PM

7400 Augusta St.
River Forest, IL 60305

Funded in whole or in part by the Illinois Department of Human Services, Division of Substance Use Prevention & Recovery through a grant from the Substance Abuse and Mental Health Services Administration.

Date of Registration Date of Registration * / MM / DD YYYY
Name Name * First Last
Title
Campus or Agency *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone * - ### - ### ####
Email *
How did you learn about this meeting? *

How did you learn about this meeting? IHEC ListServ IHEC WebSite IAODAPCA WebSite IHEC Social Media Page Snail Mail Other
Other (if indicated above)
Will you be bringing anyone with you? If so, who?
Topics or Issues you would like to see discussed at this or future meetings: *
Do you need help coordination lodging? *

Do you need help coordination lodging? yes no