Print this form and send along with your check made payable to the Chicago Area IPT.

To: Donald F. Nesci, Manager Property Taxes, Abbott Laboratories, 100 Abbott Park Road, AP6D/D0367, Abbott Park, IL 60064

Chicago Area IPT Luncheon

Registration for meeting to be held __________________________

Name: __________________________________________________________________

Company/Firm: ___________________________________________________________

Are you a member of the National IPT (circle one): Yes No

Your area of interest (circle one): Property Sales Both

Your email address: ________________________________________________________

If you are a first time attendee please fill out the information below:

Title: ____________________________________________________________________

Address: _________________________________________________________________

City: ____________________________________ State _____ Zip ________________

Phone: (______) ________ ___________ Fax: (______) ________ ___________

Name to use on name badge other than first name: _______________________________