On-Campus Program Registration

Name of Labor Center Program

Union Name and Local Number Or Organization Name

Attendee(s). Provide name, position/title, cell phone number, & email address.

Attendee(s). Provide name, position/title, cell phone number, & email address.
	Attendee(s). Provide name, position/title, cell phone number, & email address.	Item weight

more items

If language interpretation is required, please list the language(s) needed.

Email (of person submitting the registration)

Street address

City

State

Zip code

Please enter the billing/union/organization address, not a participant's home address

Payment Method

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