Coalition for Peace and Justice

Please print out and mail in:

 

COALITION FOR PEACE AND JUSTICE MEMBERSHIP FORM              

Name______________________________________________________________________________

 

Address_____________________________________________________________________________

 

Phone______________________________Email/Fax_________________________________________

 

Individual Member (25.00)_____________ Family Membership (35.00)____________

 

Sustainer (100.00)_______________   Peace Partner (365.00)_________________

 

Senior/Student/Fixed Income (10.00)______Lock Peace Fund (supports student organizing)___________ 

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SJ CAMPAIGN FOR PEACE AND JUSTICE MEMBERSHIP FORM              

Name______________________________________________________________________________

 

Address_____________________________________________________________________________

 

Phone______________________________Email/Fax_________________________________________

 

Individual Member (25.00)_____________ Family Membership (35.00)____________

 

Sustainer (100.00)_____________  Peace Partner (365.00)_________________Senior/Student/Fixed Income (10.00)________ 

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JOIN ONE GROUP,  AND YOU CAN JOIN THE OTHER FOR 10.00 MORE.  PLEASE SEND THIS FORM AND YOUR CHECK PAYABLE TO: COALITION FOR PEACE AND JUSTICE (OR USE ‘PAEF’ FOR TAX DEDUCTION), 321 BARR AVE, LINWOOD, NJ 08221. THE COALITION WILL DISPERSE YOUR DONATIONS TO THE SJ CAMPAIGN.  VISA/MASTERCARD ACCEPTED.  WRITE YOUR CARD NUMBER AND EXPIRATION DATE ON THE LINE BELOW

 

 

TOTAL AMOUNT ENCLOSED________________________________

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