Business-Led H-1B Technical Skills Training Grants

Prospective Applicants Conference

REGISTRATION FORM

Please type or print your information, as it should appear on each name badge. Duplicate this form if you have more than one person attending. The completed registration form should be faxed to Sheritta Cooper Porter at 202-289-0749 or e-mail to sporter@rea-inc.com.

Please select the site you will attend:

Dates & Sites Registration Deadline

“ July 23, 2003 – Chicago, IL July 16, 2003

“ July 29, 2003 – Washington, DC Open Ended

“ August 13, 2003 – San Francisco, CA Open Ended

PARTICIPANT INFORMATION

First Name: ___________________________________________________________________________

Last Name: ___________________________________________________________________________

Organization: _________________________________________________________________________

Title: ________________________________________________________________________________

Mailing Address: _______________________________________________________________________

City: ________________________________ State: ____________________ Zip: __________________

Telephone: ______________________________ Fax: ________________________________________

E-mail: _______________________________________________________________________________

Special Needs: “ Accessibility/Disability Assistance ___________________________________________

“ Dietary ________________________________________________________________

“ Other ________________________________________________________________

THIS FORM IS FOR CONFERENCE REGISTRATION ONLY