Asian-Pacific 2017 Conference Registration

Please provide a non-LAUSD email.
Please provide your contact number.
Emergency Contact Number Order
Please provide a emergency contact number in case of an emergency on the Manzanar Pilgrimage trip or while at the UTLA building. If you have more than one contact, please click "Add Another Item" and enter an additional number.
Salary Point Needed
Attending Workshops

Select all that apply. *For salary points you must attend all three workshops, including the Manzanar Pilgrimage.

Manzanar Bus Trip Only
Bus Pickup Locations

Please select a bus pickup location. Specifics will be sent to you closer to the date.

Let us know if you have any food allergies or require assistance or special accommodations.
Enclosed Fee

Please check the appropriate fee & mail check to: UTLA, Attn: Jenny Lam, 3303 Wilshire Blvd. 10th Floor, Los Angeles CA 90010

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