| First Name |
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| Last Name |
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| Address |
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| City |
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| State/Province |
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| Zip/Postal Code |
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| Country |
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| Daytime Phone |
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| Evening Phone |
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| Email Address |
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I want to get active locally - please tell
me who to call in my city |
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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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