IDOT Trucking Regulations Workshop
Please register by filling out the form below
Full Name
*
First Name
Last Name
Company Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
Are you an Illinois LICA member?
*
Yes
No
Payment method:
*
Mail a check
Credit card (4% convenience fee applies)
Coupon code
Non-member
Coupon code
Which location will you attend?
*
Springfield, IL: February 6
Rock Island, IL: February 13
Noble, IL: February 20
Total Number of people attending
*
Additional attendees' names:
Total for calculation
Please mail a check for the total amount shown to Illinois LICA, 112 Exchange St, Ste. 2, Galva, IL 61434
4% Calculation
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