Registration Form

Use the form below to make a secure payment with your credit or debit card. The form will connect you to our secure server to process your payment.

We accept Visa, Mastercard, American Express, and Discover, cash, or check.

Item Name:
First Name:	(required)
Last Name:	(required)
Phone:
Amount Due:	$ (add names of participants in the "note to seller" section)
PAYMENT OPTIONS:	$25: STUDENT $35: REGULAR $150: GROUP RATE (for 5 regular registrations) $250: GROUP RATE (for 10 regular registrations) -OR- Make check out to: "APA for Progress" and mail to: c/o Curtis Chin 215 S. Santa Fe Ave., #3 Los Angeles, CA 90012 -OR- Pay at the door. There will be a $5 surcharge for paying on the day of the event. Cash or check only.

APA for Progress

A grassroots, internet-empowered, national network of Asian Pacific Americans and friends for Progressive Action.

Registration Form