Drainage Workshop

Illinois LICA Safety Series

Sponsor the Illinois LICA Safety Series by filling out the form below
Full Name*

First NameLast Name
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Payment method:*

Mail a checkCredit card (4% convenience fee applies)
Exclusive "event" sponsors will receive 15 minutes during lunch for a company presentation/update. All sponsors receive signage at the event(s), on the ILICA website, & in the newsletter. Sponsorships are filled first come, first served.
Which location(s) would you like to sponsor?*

January 9-10: Decatur, ILJanuary 14-15: Mt. Vernon, ILJanuary 23-24: Lanark, IL
Decatur, IL sponsorship: Please check all that apply:

Event: $800Lunch: $600 (unavailable)Breaks: $300 (unavailable)
Mt. Vernon, IL sponsorship: Please check all that apply:

Event: $800Lunch: $600Breaks: $300
Lanark, IL sponsorship: Please check all that apply:

Event: $800Lunch: $600Breaks: $300
Event sponsors receive 15 minutes during lunch for a company presentation/update. Please provide the name(s) of company reps attending:
Please mail a check for the total amount shown to Illinois LICA, 112 Exchange St, Ste. 2, Galva, IL 61434
4% Calculation

Illinois LICA Safety Series