Act Now to Stop War & End Racism (ANSWER): Survey

Volunteer with ANSWER-FL

Volunteer with ANSWER-Florida

1.

Please complete the following:

*

Name:

First Required	Last Required

*

Email: Required

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

2.

Question - Not Required - Work Telephone:

3.

Question - Not Required - Cell phone:

4.

Question - Not Required - Please list any organizational or trade union affiliations you have, and if you are a student, what school you attend.

(Maximum response 255 chars, approx. 5 rows of text)

5.

Question - Not Required - Please check all that apply

	I want to get involved with ANSWER.
	I will donate to help ANSWER's work

6.

Question - Not Required - Please use the space below to make comments or ask questions.

(Maximum response 255 chars, approx. 5 rows of text)