Be sure to include the conference/convention you’re planning on attending. After you submit your application, text your name to 734-678-4864 to confirm. Event Registration Fields marked with an * are required Event Intro Description If you would like to take part in our event, please fill in your details in this Event Registration Form below and you will be automatically registered. Event registration must be completed at least seven (7) days prior to the event. Divider First Name * Last Name * Address * City * US States * - Select State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST ARMED FORCES AMERICA (EXCEPT CANADA) ARMED FORCES PACIFIC Zip * Email * Phone * Union and Local if any Referral if any Conference / Convention attending * 1. Briefly tell us about ourself and vour financial need. * 2. What activities or organizations are you currently involved in? * 3. What are your personal goals and aspirations? * 4. How do you plan to utilize the knowledge obtained from the conference? * If you are a human seeing this field, please leave it empty.