YES! You CAN: Preserving Safely July 28th

Please note - you DO NOT need to log in or create an account. You can bypass those fields and start with Contact Information (below).

If you have any questions or need reasonable accommodation to participate, please contact Yvonne Izquierdo at 217.244.1511 or yizqui2@illinois.edu. Early requests are strongly encouraged to allow sufficient time to meet your needs.

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Contact Information

First Name

Last Name

Street Address

Street Address 2

City

State

ZIP

Daytime Phone

Evening Phone

E-mail Address

The university plans to capture photographs and video of this event. Be aware that if you attend, you are consenting to the possibility that your image and likeness may be shared or published by the university for marketing-communications purposes. If you do not wish to be photographed, please inform the photographer.

Civil Rights Compliance - Participant Info

As part of our commitment to providing equal opportunities in our programming, University of Illinois Extension is required to collect and report overall statistics about the race, ethnicity, and gender of program participants. Your responses are voluntary and appreciated.

Gender

Ethnicity

Race