Eastside Legal Assistance Program · 2023 Breakfast for Justice Registration

Name

Prefix

First Name

Last Name

Suffix

Organization/Employer

Are you an attorney?

Yes

No

Email

Verify Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone

Table Captain

*

Who's table would you like to sit at?

Table Sponsor Name

I would like to sit with...

Dietary Restrictions

The standard meal is vegetarian and gluten-free. Breakfast meats and pastries will be served on the side.

None

Vegan

Other

Newsletter?

I would like to receive your e-newsletter.

Add guests?

Yes

Guest

Prefix

First Name

Last Name

Suffix

Organization/Employer

Guest Email

Verify Email

Guest Dietary Restrictions

None

Vegan

Other

Guest 2

Prefix

First Name

Last Name

Suffix

Organization/Employer

Guest 2 Email

Verify Email

Guest 2 Dietary Restrictions

None

Vegan

Other

Guest 3

Prefix

First Name

Last Name

Suffix

Organization/Employer

Guest 3 Email

Verify Email

Guest 3 Dietary Restrictions

None

Vegan

Other

Guest 4

Prefix

First Name

Last Name

Suffix

Organization/Employer

Guest 4 Email

Verify Email

Guest 4 Dietary Restrictions

None

Vegan

Other