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 ASQ Chicago Section 1201

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Unemployed Member Registration

To register for the section general meeting as an unemployed member, please complete the form below and select submit.

Note:

  1. By selecting "yes" to qualified you are certifying that you meet the requirement to apply for this supplement. Please see guidelines
  2. There are limited supplement assists per meeting and it is on a first come first served bases, maximum 3 for each member annually.
  3. If you wish to attend as a paying member or Program Only please use the appropriate registration form.
  4. * Phone and FAX numbers will only be used if we need to contact you about your registration. If you enter an email address, you will receive email confirmation of your registration. Please  Click here to Email Vice-chair of Programs  with questions on registration.
Name:   Phone*:  
Membership Number   FAX*:
Qualified: Yes No

email*:

 
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(Please only submit one time.  Upon reviewing confirmation page, registration has been received)

If you register, but for some reason you cannot attend, please Click here to Email Vice-chair of Programs to cancel your registration.

Cancellation must be received by 5:00 pm, Monday, Jan 9, 2012.

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