UNIS Action Items
“UKRAINIAN DAYS” Registration Form
22 March 2012
WASHINGTON, DC
April 25-26, 2012
REGISTRATION FORM
NAME _________________________________________________________
COMMUNITY ________________________________________________
CONTACT INFORMATION:
Address: _______________________________
_______________________________
Phone: _______________________________
E-mail: _______________________________
My congressman (district) in the U.S. House of Representatives:
I will arrive to Washington D.C. on ___________________________
I will require UNIS to arrange for my lodging (сircle) Yes No
I will require accommodations in Washington, D.C. for _________ nights.
Please provide us with any other information that might be relevant.
Please return this form to UNIS no later than April 18, 2012
Registration fee: FOR “UKRAINIAN DAYS” ONLY - $75
FOR “UKRAINIAN DAYS” AND 35TH ANNIVERSARY UNIS RECEPTION - $100
This form may be faxed to UNIS at: (202) 543-5502, or e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
