ISSRT Test Page – Illinois State Society of Radiologic Technologists

Program/School Name*

Contact Person*

First Last

Contact Phone*

Contact Email*

Team Information

Team Captain*

First Last

ISSRT #*

Team Member #1*

First Last

ISSRT #*

Team Member #2*

First Last

ISSRT #*

Team Member #3*

First Last

ISSRT #*

IMPORTANT – PLEASE NOTE:

- Team registration is $75 per team.
- Team registration deadline is April 1st. No exceptions!
- There will be no team registration accepted after this date.
- Faxed registrations will not be accepted.
- Team members listed above must be a member of the ISSRT prior to registration and must register for the conference.
- Documentation for membership status must accompany registration.

Judges

Each program participating in the tournament is required to provide 2 judges. Please list your volunteers below.

If you are unable to supply 2 judges, please contact the Scholar Bowl chairperson at issrt.scholarbowl@gmail.com as soon as possible.

Judge #1*

First Last

Email*

Judge #2*

First Last

Email*

Payment
Payment can be made online or by check. Please watch your email for a confirmation with instructions to pay by credit card.

Checks should be payable to: Illinois State Society of Radiologic Technologists
Mail completed registration form & payment to:
ISSRT
2515 Gecko Drive Maryville, IL 62062

Frequently Asked Questions

Team Information

Judges