Seminar and Event Registration

Thank you for registering for this upcoming program. To reserve your seat, please complete the information below. We will confirm your registration within 48 hours.

» Required Fields


» Name:
» Date of Birth:
Guest:
Guest:
Guest:
Date of Seminar/Event:
Seminar/Event Location:
» Seniority Date (NCSD):
» Job Title (Wage Scale):
Union Local (If Applicable):

Contact information is required so that we can confirm your reservation and/or make you aware of any changes to the planned program.
» Contact Phone:
» E-mail Address:
» City:
» State:

Office Name

Office Street Address

Office City, CA Office Zip

Phone: Office Telephone

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Fax: Office Fax

www.jim-retail.pfyfn.com

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Office E-Mail Address

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