Membership Registration – Pay by Check

Please complete the following form to register for membership with The Greater La Crosse Area Diversity Council. Checks should be made out to: Greater La Crosse Area Diversity Council. Include "Membership Registration" on check.

Send to:
GLADC
% Workforce Connections, Inc.
2615 East Ave S #103, La Crosse, WI 54601

Membership Level (required)

Membership Type (required)
Company/Organization MembershipIndividual Membership

Company/Organization Name (if applicable)

Your Name (required)

Your Title/Position

Address

City

State

Zip Code

Your Email (required)

Phone