The document is a registration form for the Illinois Latino Leadership Conference taking place on October 4th, 2014 from 9 AM to 1 PM at Blackhawk Community College in Moline, Illinois. The conference will focus on the Latino vote, politics, and public policy. The registration deadline is September 26th, 2014 and interested participants can register by faxing or emailing their contact information to the provided number and email address.

1. ¡TU VOTO CUENTA ILLINOIS!
Registration Form
Illinois Latino Leadership Conference
The Latino Vote, Politics & Public Policy
Saturday, October 4th, 2014
9 AM – 1 PM Blackhawk Community College
6600 34th Ave.
Moline, IL 61265
Registration deadline: Friday, September 26, 2014 please fax your registration to 319-627-2315 or email to salvaladez85@gmail.com
Name:
Title/Occupation:
Phone:
E-Mail:
Organization or School:
Address:
City:
ZIP Code:
For more information, please contact Sal Valadez, 309-340-5230, salvaladez85@gmail.com