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

LGBT Equality Now!

Endorsement Form

Please fill out this form if you want to endorse the Nov. 8 L.A. protest
for LGBT equality and same-sex marriage rights.

*1.

Question - Required - I/my organization endorses the Nov. 8 "No More Hate! Stamp Out Prop. 8!" protest in Los Angeles.

2.

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

3.

Question - Not Required - Work Telephone:

4.

Question - Not Required - Cell phone:

5.

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)

6.

Question - Not Required - Please check all that apply

	I can volunteer at the Nov. 8 Protest.
	I will donate to help ANSWER's work for LGBT equality.
	I want to get involved with ANSWER.

7.

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

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