Beruflich Dokumente
Kultur Dokumente
REGISTRATION FORM
(Please use a separate form for each attendee)
Name: ______________________________________________________________
Company/Organization: ________________________________________________
Title: _______________________________________________________________
Address: ____________________________________________________________
City/State/Zip Code: ___________________________________________________
Phone Number: ___________________________ Fax Number: ________________
E-mail: _____________________________________________________________
*This fee includes your special first year only Diversity Works! Employer Partner rate of
$1,200 and full Summit registration. Please visit our website www.ulsdc.org for additional information on the
benefits of becoming a Diversity Works! Employer Partner).
Payment Options: (Check all that apply and include the appropriate payment).
Check/Money Order: Make payable to Urban League of San Diego County, Inc.
MASTERCARD VISA
Expiration Date: ___________
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