The National Coalition to Protect Family Leave

PRINT VERSION

MEMBERSHIP INFORMATION

We are glad you want to join the National Coalition to Protect Family Leave. Membership in the National Coalition to Protect Family Leave is open to any employer, individual or organization who is strongly opposed to FMLA expansions and who shares the commitment that the FMLA should be corrected to address unintended compliance problems with the Act and its implementing regulations and interpretations. Membership entitles you to legilative and regulatory updates information, useful analysis and additional homepage access. You will also be included in special member only meetings and events.

* Indicates required information

Member Information

My courtesy title is: *
If Other (please specify):

First name: *

Middle
initial:

Last name: *

Business Name or Organization*

My title is: *

My e-mail address is: *

Type of business:

Number of
employees:

My Business/Oranization homepage address is:

Business mailing address:

City:

State:

Zip code:

Other states where your company operates:

AK	AL	AZ	CA	CO	DE	FL	GA
HI	IA	ID	IL	IN	KS	KY	LA
MA	MD	ME	MI	MN	MO	MS	MT
NC	ND	NE	NH	NJ	NM	NV	NY
OH	OK	OR	PA	RI	SC	SD	TN
TX	UT	VA	VT	WA	WI	WV	WY
DISTRICT OF COLUMBIA

My phone number at work: *

My fax number at work:

Best time to call you (Eastern Standard Time) to double-check data, where necessary, and to ask you a few questions that will help us serve you better:
8am-11am 11am-2pm 2pm-5pm

How did you learn of the National Coalition to Protect Family Leave?

Enter the text above:

For federal income tax purposes, 10% of your contribution is deductible as a business expense.