Immigrant Rights and Community Wellness registration form

Immigrant Rights and Community Wellness Registration Form
This is a free online workshop offered by The Immigrant Leadership Institute at The Welcoming Center on Wednesdays from July 9 to July 23 from 6:00 pm to 8:00 pm.

Attendance and participation in all 3 sessions are highly recommended.
Please register by completing this form.
CONTACT INFORMATION
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Telephone Number*
Please enter a valid phone number.
What is your date of birth?

MonthDayYear
What is your country of origin?*
What is your highest level of education?*
What is your profession or occupation?*
What are your expectations of this workshop?*
Attended Info Session
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Immigrant Rights and Community Wellness Registration Form