First Name Last Name
Address
City State Zip
E-mail Phone
Employer

Please tell us about your WAGE Club. How many times have you met? How many people are in your group? What was accomplished in these meetings? Is there any news that you can share about the steps you and your WAGE Club participants have taken to get even at work. Has your group experienced any major successes? Any setbacks? Does your group have any suggestions to improve the discussion guide? Please provide as much detail as possible.

</txtarea><brk><brk><p>Has your WAGE Club gained any new participants? Please submit information below.<brk><brk><p>First Name <input type=text name=member1-firstName class=f> Last Name <input type=text name=member1-lastName class=f><brk><br>Address <input type=text name=member1-address class=f><brk><br>City <input type=text name=member1-city class=f> State <input type=text size=2 name=member1-state class=f> Zip <input type=text name=member1-zip class=f><brk><br>E-mail <input type=text name=member1-email class=f> Phone <input type=text name=member1-phone class=f><brk><br>Employer <input type=text name=member1-employer class=f><brk><brk><p>First Name <input type=text name=member2-firstName class=f> Last Name <input type=text name=member2-lastName class=f><brk><br>Address <input type=text name=member2-address class=f><brk><br>City <input type=text name=member2-city class=f> State <input type=text size=2 name=member2-state class=f> Zip <input type=text name=member2-zip class=f><brk><br>E-mail <input type=text name=member2-email class=f> Phone <input type=text name=member2-phone class=f><brk><br>Employer <input type=text name=member2-employer class=f><brk><brk><p>First Name <input type=text name=member3-firstName class=f> Last Name <input type=text name=member3-lastName class=f><brk><br>Address <input type=text name=member3-address class=f><brk><br>City <input type=text name=member3-city class=f> State <input type=text size=2 name=member3-state class=f> Zip <input type=text name=member3-zip class=f><brk><br>E-mail <input type=text name=member3-email class=f> Phone <input type=text name=member3-phone class=f><brk><br>Employer <input type=text name=member3-employer class=f><brk><brk><p>First Name <input type=text name=member4-firstName class=f> Last Name <input type=text name=member4-lastName class=f><brk><br>Address <input type=text name=member4-address class=f><brk><br>City <input type=text name=member4-city class=f> State <input type=text size=2 name=member4-state class=f> Zip <input type=text name=member4-zip class=f><brk><br>E-mail <input type=text name=member4-email class=f> Phone <input type=text name=member4-phone class=f><brk><br>Employer <input type=text name=member4-employer class=f><brk><brk><p>First Name <input type=text name=member5-firstName class=f> Last Name <input type=text name=member5-lastName class=f><brk><br>Address <input type=text name=member5-address class=f><brk><br>City <input type=text name=member5-city class=f> State <input type=text size=2 name=member5-state class=f> Zip <input type=text name=member5-zip class=f><brk><br>E-mail <input type=text name=member5-email class=f> Phone <input type=text name=member5-phone class=f><brk><br>Employer <input type=text name=member5-employer class=f><brk><brk><p>First Name <input type=text name=member6-firstName class=f> Last Name <input type=text name=member6-lastName class=f><brk><br>Address <input type=text name=member6-address class=f><brk><br>City <input type=text name=member6-city class=f> State <input type=text size=2 name=member6-state class=f> Zip <input type=text name=member6-zip class=f><brk><br>E-mail <input type=text name=member6-email class=f> Phone <input type=text name=member6-phone class=f><brk><br>Employer <input type=text name=member6-employer class=f><brk><brk><p><input type=submit name=submit value=Submit><brk><brk></form> </td> <td><img src="../graphics/clear.gif" width=1 height=430 border=0 alt=""></td> </tr> <tr> <td width=559><img src="../graphics/clear.gif" width=559 height=1 border=0 alt=""></td> <td width=1><img src="../graphics/clear.gif" width=1 height=1 border=0 alt=""></td> </tr> </table> </td> </tr> <tr> <td bgcolor="#b2b2b2" align=left> <table border=0 cellspacing=0 cellpadding=0> <tr> <td><img src="../graphics/clear.gif" width=5 height=1 border=0 alt=""></td> <td class=s><b><a href="../wage/termsofuse.php" class=b>terms of use</a></b></td> <td><img src="../graphics/clear.gif" width=15 height=1 border=0 alt=""></td> <td class=s><b><a href="../wage/privacy.php" class=b>privacy policy</a></b></td> <td><img src="../graphics/clear.gif" width=15 height=1 border=0 alt=""></td> <td class=s><b><a href="../list/index.php" class=b>join the WAGE list</a></b></td> <td><img src="../graphics/clear.gif" width=15 height=1 border=0 alt=""></td> <td class=s><b><a href="../wage/contact.php" class=b>contact us</a></b></td> </tr> </table> </td> <td bgcolor="#b2b2b2" align=right><p class=s><b>Copyrighted by <a class=b href=../../index.php>The WAGE Project</a> </b></td> </tr> </table> </td> </tr> <tr><td width=740><img src="../graphics/clear.gif" width=740 height=1 border=0 alt=""></td></tr> </table> </center> <script type='text/javascript'> function Pop_Go(){return} function PopMenu(x,y){return} function OutMenu(){return} </script> <script type='text/javascript' src='../../popmenu_var.js'></script> <script type='text/javascript' src='../../popmenu_com.js'></script> </body> </html>