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

Oct. 7 & 17 Endorse and Volunteer

Endorse & Volunteer Today

Please fill out this form if you/your organization would like to endorse the October 7 U.S. Out of Afghanistan Protest in Los Angeles, and the October 17 Anti-War Teach-In. You can also sign up to volunteer at or before the actions. October 7 is the 8th anniversary of the U.S./NATO criminal war on the people of Afghanistan.

*1.

Question - Required - I/my organization endorses the October 7 Los Angeles U.S. Out of Afghanistan Protest, and the October 17 anti-war teach-in.

2.

Please complete the following:

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Name:

First Required	Last Required

*

Email: Required

Street 1:

City/State/ZIP:

City	State	ZIP

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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 check all that apply

	I will volunteer to help build the October 7 & 17 actions.
	I will attend the October 7 Protest.
	I will volunteer at the Protest.
	I will attend the October 17 Teach-In.
	I will volunteer at the Protest.
	I will donate to help ANSWER's anti-war work.

6.

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)

7.

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

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