EQUITY OR ELSE

    REGISTRATION FORM-EQUITY OR ELSE: Quality of Life Agenda

    Event Date: May 17-18, 2021

    Event Address: Black Lives Matter Plaza | Washington, DC

    Contact us at info@j4jalliance.com

    IMPORTANT- One registration per attendee.. that applies to youth and students

    * Required







    EAST ( Boston, Rhode Island, Conneticut, etc.)MID-ATLANTIC (New York, New Jersey, Delaware, Baltimore etc.)MID-WEST ( Pennsylvania, Illinois, Kansas, Ohio, etc.)SOUTH (Texas, Arkansas, Mississippi, etc.)WEST ( California, Washington, Oregon, etc.)

    EducationHousingHealthcareEnvironment / ClimateSafetyOther:

    Day 1-May 17, 2021Day 2-May 18, 2021I will be attending Both Days

    Driving-Car/VanOrganizing a Bus- please email info@j4jalliance.com for more info-include transportation in the subject lineTrainAirplane

    YesNo