Required Information - Last Name; First Name; Email; Phone; Zip

Select primary area of interest. This selection does not prevent participation in other areas.

FULL NAME:

EMAIL:

PHONE:

ZIP CODE:

My interests are: Select Ambassador - Attend government meetings and social events Media Correspondent- Locate and submit relevant stories Promoter - Meet people and share important information with them. Fundraiser - Develop and manage campaigns to help offset cost of activism. Event Coordinator - develop and manage events to raise funds and awareness of issues. Social Media Manager - Manage Facebook, Twitter, Instagram and other Social Media platforms. Membership Team - Help develop and manage programs to increase membership. Other - (Email your other interests and/or suggestions).

MESSAGE:

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