Name
Company/Organization
Address
City
State
Zip
E-mail
Re-enter e-mail
Phone
Fax
I want to participate in the following action (please choose one):
Charlotte's Housing Crisis
Child and Elder Care
Violence Against Women and Girls
Healthy Women and Healthy Girls
Pay Equity/Life Equity
Political Leadership
I volunteer to support the following (check as many as apply):
Fundraising
Marketing and public relations
Website content
Advocacy and Outreach
(letters to elected officials, presentations to local and state governmental bodies,
community organizations and other groups)
Facilitating or participating in focus group discussions and interviews
Research
Other
I prefer (choose one):
To serve on an ad hoc or as needed basis.
To be a regular member of an ongoing committee or action team
Neither
Please keep me on the e-mail list to receive periodic updates
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