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If you prefer to print a copy of the form and mail or fax it to us, please Click Here.

Please complete the following form (all fields are required) and click on the "submit" button. 
District:
Address:
City: State: Zip:
Phone:
XXX-XXX-XXXX		 Fax:
XXX-XXX-XXXX
 

Name:
(1st Registrant)

  
Title:
(1st Registrant)
Email Address:
(1st Registrant)
 

Name:
(2nd Registrant)

  
Title:
(2nd Registrant)
Email Address:
(2nd Registrant)
 

Payment
Please select your form of payment.
I will pay by check
I will pay by credit card (Visa, MC, American Express, Discover)

If you would like a copy of this form for your records, please print this page before clicking the "Submit" button.

             

Employment and Labor Law in California