Request Information

Name*
First Last
Applicant email*
Applicant phone*
State ZIP Code
Has the COVID-19 crisis affected you or a family member's employment?
- YES
- NO
What is your or the AFSCME member's status with the union?*
Are you the union member?*
- YES
- NO
Name of AFSCME member*
First Last
Where is the AFSCME Member employed?
Relationship to AFSCME member?
What is the member's AFSCME membership number?
What is the member's local number?
What is the member's council number?
By clicking submit, I agree that Eastern Gateway Community College and its affiliates may email me or contact me regarding educational services by telephone and/or text message utilizing automated technology at the telephone number(s) provided above. I understand this consent is not required to attend EGCC.
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