GovState's 56th Birthday General Registration

Registration Information

Registration Type

Registering as an Individual(s)

Registering as an Event Sponsor

I am unable to attend, but would like to contribute

CLICK HERE to sponsor this event

Upon selection of your sponsorship level, you will receive an invoice with sponsorship details and payment information. Thank you for sponsoring this event.

CLICK HERE TO DONATE

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Attendees
Attendee Type* First Name* Last Name* Birthdate* Birthdate* Email Address* Why we ask for your birthday: Your birthday helps us match your contributions to your donor profile irrespective of changes to your postal and email addresses. Please select this guest's connection to Governors State University Select all that apply Please select this guest's connection to Governors State University Select all that apply Community Member Current GovState Employee Current GovState Student Elected or Appointed Official Former GovState Employee GovState Alumnus Volunteer Other Please describe:

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Media Release

I hereby consent to the use, publication, broadcast, telecast, distribution and circulation of my name, photograph, image, and/or likeness by Governors State University (GovState) in any GovState-sponsored product and/or publication used for recruiting, promotional, advertising, or commercial purposes, and shall include, but not limited to, the GovState website, newsletters, catalogs, schedules, handbooks, and brochures. I further understand and agree that this picture release consent shall remain in full force and effect until canceled in writing and in reasonable advance of any said publications.

I have read the foregoing Media Release Consent. I fully understand its content and am voluntarily agreeing to this media release consent as a free and voluntary act.

Please type your first and last name.*