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Nurse Lobby Day 2010 Signup
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Nurse Lobby Day 2010
Please register by filling out this form
Name
--Select--
Dr.
Mr.
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Ms.
Title
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First Name
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MI
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Worksite
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Food Restrictions
'Food Restrictions' is required
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Roomate Preference
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Scrub Size
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Your Legislator's Names
'Your Legislator's Names' is required
'Your Legislator's Names' is required
SEIU Cope Contributor
Yes
No
'SEIU Cope Contributor' is required
Thank you!
Nurse Lobby Day 2010
April 21 and 22, 2010
Deadline to sign up is April 2, 2010
Members who would like to sign up must be COPE Contributors
Please remember to apply for PL Time
If you have any questions, please call 305-620-6555
