First Name*

Last Name*

Phone

Mobile

Email*

Street

City

State/Province

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Policy Interests: (Use cmnd+click or ctrl+click to select more than one)
Criminal Justice ReformCivil Liberties / PrivacyDeath Penalty RepealEconomic JusticeGLBT Equality / Human RightsImmigrant RightsNonviolencePalestine-Israel Human RightsPeace/Anti-War/MilitarismPolice AccountabilityRacism / Racial Equity & Justice

Volunteer Interests: (Use cmnd+click or ctrl+click to select more than one)
Connecting PJALS to other groupsData entryDesigning fliers or other materialsDonate food to events (vol)Event planning or help at eventsFundraisingGathering signaturesHelp organize annual Action ConferenceHosting a house partyInviting your friends to eventsLeaflettingLegal ExpertiseMailingsMembership WorkOffice WorkOutreach tablingPhone callsPro Bono ServicesProviding ChildcarePublic SpeakingRural organizing / outreachSign-holdingSinging / MusicStreet TheaterTaking digital photosTaking videoTidy/CleaningTrain to join Peacekeeper teamTruth in RecruitmentWriting a Letter to the EditorWriting for the newsletter or websiteYouth and Student outreach/organizing


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Are you a human? What is Nine – 6 plus zero?*

Choose the answer from the picklist.
–None–Tree332Threefour11

Thanks!

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