| * Organization Telephone Number |
|
| * Organization E-mail Address |
|
| Organization Web Site Address |
|
* Job Title:
(Director, President, Lead Organizer, etc.) |
|
Address
(if different than above) |
|
Address 2
(if different than above) |
|
Address 3
(if different than above) |
|
* Telephone Number
(if different than above) |
|
* E-mail Address
(if different than above) |
|
* Type of Organization
(you may select more than one) |
Activist
Grassroots
Non-profit
Student
Educational
Fraternal Societies
Charitable
Religious
|
Political party
Campaign committee
Scientific
Literary
Employee associations
Hobby or recreational
Country club
|
Government
Civic league
Social welfare
Labor
Agricultural
Trade associations
Chambers of commerce
Other....
|
* Age of Organization
(in years) |
|
