On-Line Registration Form

Project Review Workshop

East-West Gateway Council of Governments
1 Memorial Dr., Ste 1600
St. Louis, MO
 

MISSOURI

Wednesday, May 17, 2017
9:30 am - 3:00 pm
OR
Wednesday, May 24, 2017
 9:00 am-noon

at
East-West Gateway Offices
1 Memorial Dr., Ste 1600
St. Louis, MO  63102

ILLINOIS

Thursday, May 18, 2017
9:30 a.m.-3:00 pm

at
IDOT - District 8
Regional Room
1102 Eastport Dr.
Collinsville, IL  62234

      Registration Deadlines:
      Missouri:
           for May 17th Workshop: May 12, 2017, at 12:00 noon
           for May 24th Workshop: May 19, 2017, at 12:00 noon
      Illinois: May 15, 2017, at 5:00 pm

Attendance at this workshop is not required to submit a final project application. Agencies must bring at a minimum their preliminary project application for review. Please bring no more than two projects for review.

Attendees are responsible for their own parking expenses.

Preliminary application must be completed prior to the registration deadline.

Registration Information:

Note:  fields marked with an "*" are required fields
Enter your name and title as you want it on your nametag

First

Last

 Name:*

Sponsor:

Leave organization
blank if same as sponsor

Organization:

Title/Position:

       Address:

City:

State:

Zip:

Telephone:

Fax:


Project Name:*

Project Limits/Description:

Type of Project:  TAP

MISSOURI WORKSHOP: 05/17/17
Preferred session time:

MISSOURI WORKSHOP: 05/24/17
Preferred session time:

ILLINOIS WORKSHOP: 05/18/17
Preferred Session Time:

E-mail Address:* 

If you have any questions, or need special assistance, please contact Jason Lange at 314-421-4220 or 618-274-2750 or e-mail him at jason.lange@ewgateway.org

 

All information obtained through this registration is kept private and will not be shared with any other company or organization)