2015 Conference Reg Form

AFRAM IS A NATIONAL CAUCUS FOR SEIU MEMBERS AND STAFF OF AFRICAN DESCENT
2015 National Leadership Conference Registration Form
The National Leadership Development Conference will be held
from:
April 17 to April 19, 2015
The Westin Detroit Metropolitan Airport
2501 Worldgateway Place
Last Name
Detroit, MI, 48242
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First Name
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Home Address
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City/State/Zip
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Home Phone
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Cell Phone
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E-mail Address
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SEIU Local
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Check Region
Central
East
South
West
__________ Early Registration
$100.00
Conference fee received by March 27, 2015
__________ Late Registration
$125.00
Conference fee received after March 31, 2015
__________ On Site Registration $150.00
On site conference fee during the conference
Make check payable to: SEIU AFRAM
Mail Check and Registration form to:
SEIU AFRAM ▪ 1673 Columbia Road NW, ▪ Suite 100 ▪ Washington, D.C. 20009