Please submit a separate registration form for each individual within a group.

Your OCLC symbol (if applicable):

Please type your name and address below.

Name

Institution

Street or P.O. Box

City/State/Zip Code

Email

Home Phone

Depending on Program Fees, please choose one:

Deduct from Deposit Account
Payment by Charge Card (MasterCard/Visa only), will call Tom Klement 608.263.4962
      with card information--Tuesdays and Thursdays are best.
Payment by Check, payable to "WiLS," will be mailed to Tom Klement,
      WiLS, 728 State St., Room 464, Madison, WI 53706.
 
 To Reset Form

If you have questions, special needs or registration questions, please phone 608.263.5051.

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