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Student name*
First Last
Student email*
Student phone*
Student address*
Street Address City ZIP / Postal Code
State/Region*
What is your (or your family member's) union affiliation?*
Has the COVID-19 crisis affected you or a family member's employment?
- YES
- NO
Local union number? (you may enter not sure or no local)*
What is your union status or relationship to the union member?*
First name of union member*
Last name of union member*
Union member phone number*
Union member email*
Union member address*
Street Address City ZIP / Postal Code
Council number
Union member state/region*
Where is/was the union member employed?
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.
Send me email updates
- Yes, send me e-mail updates about Union Plus benefits and discounts.
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