| First Name |
|
| Last Name |
|
| Address |
|
| City |
|
State/Province
(select "Non USA or Canada" for
countries
outside of North America) |
|
| Zip/Postal Code |
|
| Country |
|
| Daytime Phone |
|
| Evening Phone |
|
| Email Address |
|
| |
|
I want to get active locally - please tell me
who to call in my city |
|
I can send dollars to help out financially |
|
Send me an information packet so that I can act
locally |
I want to.... |
|
Help start or organize a local action center |
| Ask
my group or congregation to sign a resolution
for the Moratorium Now campaign |
| Write
letters to the editor |
| Participate
as as online activist |
| Raise
funds for continuing the struggle |
|
Visit with my legislative representative to
lobby for a moratorium |
| |
Please
tell us something about yourself and what you
want to do, so that we can do a better job of
matching you with the work that needs to be
done.
|
|
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