Carrier Registration - Local Union 295 Wellness Fair

CONTACT INFORMATION

Name*

First & Last

Company*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone/Cell*

Email*

INFORMATION YOU WILL BE PROVIDING EMPLOYEES*

DO YOU NEED ELECTRICITY:*

LIST PRIZE YOU WILL BE DONATING FOR RAFFLE ($25-$50 VALUE)*

Choose the Health Fair(s) You Will be Attending

Choose below*

Local Union 295 Member Health Fair 5/10/25 - 10am-3pm

By clicking on the 'CAPTCHA' box below and submitting this form you are entering into an agreement with and committing to the Corporate Health Fairs Policies.

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