Lobby Day May 19, 2017 - Bus Transportation Sign Up Sheet
This registration form works best in Google Chrome, Firefox, or Safari. It will not work properly in Internet Explorer. Click on the line under the question to start typing. If you need help please email Events & Travel at
events@calnurses.org
or call at 510-433-2765.
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First Name:
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Last Name:
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Cell Phone
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e.g. (987) 654-3210
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Organization:
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State Assembly Member (if known):
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State Senator (if known):
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Please list any food allergies / restrictions or special needs accessibilty requests:
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