Lobby Day Bus Form

Back to Home

Lobby Day Sign Up

Fill out the form below to sign up to attend lobby day with SEIU Local 73.

Name

Fill in your name.

Title

First Name *

Last Name *

Suffix

Home Address

Fill in your address.

Address 1 *

Address 2

City

State

Postal Code

Country

Employer

Fill in the name of your employer.

* 'Employer' is required

Employer Location

Fill in the location of your employer.

* 'Employer Location' is required

Job Title

Fill in the name of your position.

* 'Job Title' is required

Bus Location

Which bus location will you be leaving from?

* 'Bus Location' is required