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2012 Adjunct Appreciation Reception
Tuesday, May 8, 2012
5:00 p.m. - 7:00 p.m.
The Madison Club
5 East Wilson Street
Madison, WI 53703
Telephone: 608.255.4861
Business attire
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1
. First Name:
First Name:
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2
. Last Name:
Last Name:
*
3
. E-mail Address:
E-mail Address:
*
4
. Contact Information:
Contact Information:
Company:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
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HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
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ND North Dakota
MP Northern Mariana Islands
OH Ohio
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OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Phone Number:
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5
. Are you a University of Wisconsin Law School Alum?
Are you a University of Wisconsin Law School Alum?
Yes
No
If yes, please enter your class year:
*
6
. Number Attending:
Number Attending:
*
7
. I will be bringing a guest(s):
I will be bringing a guest(s):
Yes
No
If yes, please enter the name of your guest(s) and company/organization for their name badge:
8
. I would like to send my regrets:
I would like to send my regrets:
I am unable to attend.
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