UIC Open House Reservation Card

* indicates required fields

Event Date and Time: 10/5/2013 9:00 a.m. - 2:00 p.m.
Event Type: Fall 2013 Open House Program at UIC
Location:UIC Forum, 725 West Roosevelt Road, Chicago, Illinois 60608
Reservation E-mail Address:*
First Name:*
Last Name:*
Phone Number:*
(Please enter the phone number starting with area code and no spaces.ex:3129969999)
Total number of people in the group: (for groups greater than 9 please contact UIC Recruiting at 312-413-4081)
Organization Name/Affiliation:
Your Institution's CEEB Code: