8/9/2018 Lakewood Basic Sales and Use Tax Workshop * Required fields: First Name, Last Name, Street, City, State, Zip/Postal Code, E-mail Address, and Phone Number Name Title: *First Name: *Last Name: Mailing Address *Street: *City: *State: Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *Zip/Postal Code: Ex: 55555 or 55555-4444 Contact Information *E-mail Address: *Phone: Ex: 916-123-4567 Business/Organization: Other Information Type of Business: Agriculture Architecture Arts, Entertainment, and Recreation Automotive Repair Aviation Bars Carpet and Upholstery Cleaning Services Certified Public Accountants Child Day Care Services Communications Computer Design Services Computers and Software Construction Consulting Counseling Dentists Educational Services Electrical Engineering Environmental Fashion Finance and Banking Fishing and Hunting Fitness Forestry Funeral Furniture Gasoline Stations Graphic Design Services Hobbies Hotels & Motels Industrial Information Management Insurance Interior Design Services Jewelry Landscaping Legal Locksmiths Manufacturing Marketing Medical Field Motion Picture and Video Industries Moving and Storage Payroll Services Pet and Pet Supplies Stores Pharmacies and Drug Stores Photography Studios Physicians Plumbing Printing & Publishing Radio Stations & Television Radio, Television, and Other Electronics Stores Real Estate Restaurants Retail Trade Salons Supermarkets and Grocery Tax Preparation Services Tobacco Stores Trucking Veterinary Services Wholesale Trade Type of Nonprofit: Accounting Association Activism and Social Advocacy Alumni Assisted Living Booster Club Business Associations Chamber of Commerce Child Day Care Services Civic and Social Organizations Community Organizations Convention and Visitors Bureaus Cultural Organizations District Office Dwelling-Related Associations Educational Services Emergency and Relief Services Employees' Association Environment, Conservation and Wildlife Organizations Fraternal Organizations Government Grant making foundations Health Services Hobbies Hospitality Human Rights Organizations Labor Unions and Organizations Library Media Medical Field and Related Associations Museums Non-Profit Assistance Political Organizations Professional Organizations Radio Stations & Television Religious Organizations Residential Care Facilities Small Business Administration Small Business Development Center Social Advocacy Organization Sports Associations University / College Veterans Organizations Vocational Rehabilitation Services Youth Organizations Reasonable Accommodations Language Accommodation: Request Accommodation Specify Accommodation Language: Sign Language: Request Sign Language Visual Impairment: Request Visual Accommodation Other Accomodation: Request Other Specify Other Accommodation: Please fill out one form for each person participating.
