Conference Registration Form and Membership Application

 

Electrical Workers Minority Caucus

16th Annual National Meeting

 

January 12 - 15, 2006

 

Hilton Houston Post Oak

2001 Post Oak Boulevard, Houston, TX 77056

 

Special EWMC Sleeping Room rates available on a first come first serve basis.

Reservations: www.hilton.com or 1-800-HILTONS or 713- 961-9300

 

Please submit a separate form for each delegate.

 

The $190.00 conference registration fee includes $40.00 for membership dues.

Please check the appropriate box.

 

$190.00 for conference registration and 2006 EWMC membership dues

 

$150.00 for conference registration only

 

$40.00 for 2006 EWMC membership dues

 

Name ________________________________________________________________________

 

Mailing Address ________________________________________________________________

[Street]

 

_____________________________________________________________________________

[City, State and Zip Code]

 

Telephone Numbers ____________________________________________________________

 

Member of IBEW Local Union No. _____________ Vice-President District No. ______________

 

Current Job Classification ________________________________________________________

 

Current IBEW Local Union or International Job Classification ____________________________

 

 

Please make your check or money order payable to:

 

Electrical Workers Minority Caucus (EWMC)

PO Box 642

El Cerrito, CA 94530

 

EWMC Conference Registration Questions: (510) 848-6714

Pre-Registration Deadline January 5, 2006

On-site registration starts Thursday, January 12, 2006 at 3:00 p.m.

No Conference Pre-Registration Refunds will be made after January 5, 2006