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

Payment Method

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