University of Southern Indiana - Outreach and Engagement

NRM

2009 Norwegian Road March Registration

Full Name:
Street Address:
City, State, Zip:	City State Zip
Telephone:
Email Address:
University/Organization Name:
T-Shirt Size:

List any information of which we should be aware:
(i.e., known allergies or medical conditions)

Please Note:

Please forward your $25 registration fee NLT 31 October 2009.

Forms cannot be processed until fees are received. Walk-up fees and forms will not be accepted the day of the event due to logistical purposes.

ONLY UNIVERSITY FUNDS or FUND RAISER FUNDS CAN BE USED FOR PAYING REGISTRATION FEES, NO OMA FUNDS ARE AUTHORIZED

8600 University Boulevard - Evansville, IN 47712-3596 - 812/464-8600