Registration

To register for the Lilly Conference on College and University Teaching - East, please complete the following Registration Form. We'd like to remind you that the deadline for registration is March 26, 2005. The conference registration fee is $425.00. However, if you are a member of a team of three or more persons from the same institution, which then becomes a cosponsoring institution, the Lilly-East Conference, the cost of the full conference is reduced to $375.

Once you have filled out all the below information, you may register for the Lilly Conference on College Teaching - East one of two ways:

  1. Print out this form and send it along with a check made out to Towson University for the appropriate amount to:

    Donna Guillott
    Academic Programs, ADM 212
    Towson University
    8000 York Road
    Towson, MD 21252-0001

  2. You may print out this form with credit card information and fax it with credit card information filled in to 410-704-4849. Please be sure to sign the form before you fax it to us.

No registrations will be accepted without payment.

Please note: this form will not be directly submitted to Towson University by pressing the button at the bottom of the page. It is your responsibility to print the form and fill in any missing information by hand. A signature is also necessary.

For information contact Donna Guillott (dguillott@towson.edu) at 410-704-3828.

First Name:
Middle Name:
Last Name:
Nametag: First Name Middle Name
Are you submitting a proposal for the conference? Yes No
Department:
Institution:
Mailing Address:
City:
State/Province:
ZIP/Postal Code:
Country:
Work Phone Number:
Fax:
Home Phone Number:
E-Mail Address:
Indicate Special Needs:
Registration Fees
Lilly Conference on College Teaching - East: