REGISTRATION FORM-EQUITY OR ELSE: Quality of Life Agenda
Event Date: May 17-18, 2021
Event Address: Black Lives Matter Plaza | Washington, DC
Contact us at info@j4jalliance.com
IMPORTANT- One registration per attendee.. that applies to youth and students
* Required
EAST ( Boston, Rhode Island, Conneticut, etc.)MID-ATLANTIC (New York, New Jersey, Delaware, Baltimore etc.)MID-WEST ( Pennsylvania, Illinois, Kansas, Ohio, etc.)SOUTH (Texas, Arkansas, Mississippi, etc.)WEST ( California, Washington, Oregon, etc.)
EducationHousingHealthcareEnvironment / ClimateSafetyOther:
Day 1-May 17, 2021Day 2-May 18, 2021I will be attending Both Days
Driving-Car/VanOrganizing a Bus- please email info@j4jalliance.com for more info-include transportation in the subject lineTrainAirplane
YesNo