Return this page to Office of Women's Affairs, M/C 363, 802 University Hall

Registration: Deadline is Friday, April 22nd Fee: $15.00

Please make checks payable to UIC.

No refunds after April 25th.Late registration fee: $20.00

*Note: To make registration returns more convenient for people working on the west side of campus, please drop off your registration(s) with payment at: UIC Hospital (1740 W. Taylor), First Floor, Suite 1500. Attn: Kim Kramer or Maria Flores.

Payment must accompany registration form.

No emailed or faxed registrations will be accepted.


Sponsorís Name: _____________________________________


Department: ________________________________________

Email: ________________________________________


Campus phone# and Mail Code: ___________________________


Girlís Name (Girls must be between ages 9~15) :________________________


Name & campus phone# of person picking up the girl:_______________________

*It is our policy that all participants must leave the event accompanied by their sponsor or an adult.


If a participant has a disability and requires an accommodation, please contact Alana Stegich at (312) 413-1025 at least one week in advance of the event.


Will sponsor be attending the morning program?††††††††††Yes†††††† ††††††††††††No


Please mark 1st, 2nd, and 3rd choices of activities

_____UIC Police†† _____ Nursing School
_____Theater _____Early Childhood Ed
_____ Physics _____Dentistry
_____ Library _____Pharmacy
_____ Computer Center _____Photography
_____ Nursing at the ER _____Comic Book Design
_____Designing Daughters _____Archaeology



[†† ] I would like to be a Chaperone†and accompany my girl on her tour site †

[†† ] I would like to help with registration††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††