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Jews in Solidarity with Palestine Signer Data Entry

YES! I want to DATA ENTER a name to add to the list of signers of the Jews in Solidarity with Palestine statement.

Enter all the information you know. No fields are required, but Name, title, organization, city and state are important for listing the endoresement.

First Name:
Last Name:
Title or Position:
Organization, union or school:
I endorse:
My organization endorses:
Address:
Address 2:
City:
State:
Zip or Postal Code:
Country:
Email Address:
Phone (area code first):
Work Phone:
Cell Phone:
Fax:
Website:
I can volunteer to help with
(select all that apply):
Comments:

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UPDATED Jan 13, 2009 8:44 PM
International Action Center • Solidarity Center • 147 W. 24th St., FL 2 • New York, NY 10011
Phone 212.633.6646 • E-mail: iacenter@iacenter.org • En Español: iac-cai@iacenter.org