WA Lobby Day RSVP Form

Washington Lobby Day RSVP

Yes! I will attend SEIU Healthcare 775NW's Annual Lobby Day on February 9, 2009 in Olympia, WA.

Name

Title

First Name

MI

Last Name

Suffix

Name for Name Tag

First Name or Nickname

'Name for Name Tag' is required

Mailing Address

Address 1 *

Address 2

City

State / Province / Region

Postal Code

Country

Street Address

Only if different than your mailing address.

Address 1

Address 2

City

State / Province / Region

Postal Code

Country

Evening Phone

- ###

####

Day Phone

- ###

####

Cell Phone

- ###

####

Email Address

I prefer to be reached by the following:

Evening Phone
Day Phone
Cell Phone
Email

Are there any special needs that we should be aware of? If yes, please list below:

I need interpretation in:

Russian
Spanish
Vietnamese
Korean

Transportation

I will be taking the free union bus
Although parking will be difficult, I will drive my own car

# of people I am willing to drive (including myself)

'# of people I am willing to drive (including myself)' is required

Thank you for submitting your RSVP for Lobby Day - Monday, February 9, 2009.