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RPEC Legislative Day – Registration Form

2019 Legislative Day Registration Form

Please RSVP to the office no later than Wednesday, January 16th. 

Questions? Email Jennifer Blazian at jennifer@rpecwa.org or call toll-free 1-800-562-6097.

Name:

Email Address:

Chapter:

Legislative District:

Phone Number:

Mailing Address

Registering as:
RPEC MemberWEA-Retired MemberGuest - A registration fee of $50 is required.

Attending: (select all that apply)
Training Session (Lunch & refreshements provided)Meetings with LegislatorsReception (light Hor D'Oeuvres & refreshments provided

Lunch: Will include an assortment of refreshments, sandwich, fruit, potato chips, and a cookie. Please indicate your sandwich selection:
Tuscan Beef on Hoagie: sliced sirloin, garden crisp spinach, sun dried tomatoes, onions, mayonnaise, provolone and parmesanBlack Forest Ham on Rye: black forest ham, swiss cheese, crisp lettuce, tomato, red onion, and honey mustardCalifornia Turkey Club on Ciabatta: sliced turkey, lettuce, tomato, crisp applewood bacon, swiss cheese, avocado, and mayonnaise* with Gluten-free bread substitute

- OR -

A substitute lunch can be provided to accommodate attendees with any of the following dietary restrictions, please indicate all that apply:
Dairy FreeDiabeticVegetarianVegan

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