Act Now to Stop War & End Racism (ANSWER): Survey - Jan 10, 2009, Transportation Form

Jan 10, 2009, Transportation Form

Organize transportation to the Jan 10, 2009, March on Washington for Gaza!

Filling out this form means that you/your organization are working with other people and groups in your city, school, community, place of worship, union or workplace to bring people to Washington, D.C., on Saturday, January 10, 2009, for the March on Washington for Gaza.

Question - Not Required - Name of group:

Question - Not Required - Contact person(s):

Information to list on web page:

*

Question - Required - Email:

Question - Not Required - Phone:

Question - Not Required - Address:

*

Question - Required - City:

*

Question - Required - State:

*

Question - Required - Zip:

*

Question - Required - Country:

If you do not want all of your information publicized but can provide it for communication with event organizers, fill out the below blanks:

*

Name:

First Required	Last Required

Email:

Street 1:

City/State/ZIP:

City	State	ZIP

Country:

*

Phone Number: Required

Yes, I would like to receive e-mail from you about upcoming events and issues.

Yes, I would like to receive postal mail from PEP

Question - Not Required - Provide details about transportation plans (including the type of transport, time of departure and arrival, cost and how to buy tickets):

Question - Not Required - Additional questions or comments:

(please press the "submit" button when you are finished filling out this form)

thank you!!!