NAME:

OCCUPATION:

ADDRESS:

CITY, STATE, ZIP:

PHONE:

E-MAIL: 

I am interested in helping the chapter by doing the following:

  Outreach Committee (increasing membership and chapter publicity)

Meeting Arrangement Committee

Faith Groups Outreach & Education (forming clergy networks, mobilizing communities of faith)

Media-watch (monitoring radio, tv, newspaper coverage and writing, calling and/or editorial visits)

Legislative Response (writing, calling, and/or visiting legislators)

  I have special skills (described below) that can benefit the chapter: