00200-signin

  • October 2019
  • PDF

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Supreme Court House Party Sign-In Name:

Phone:

E-mail Address Please print legibly:

Mailing Address:

City, State ZIP:

Fill out during meeting: Team:

Name:

Phone:

E-mail Address Please print legibly:

Mailing Address:

City, State ZIP:

Fill out during meeting: Team:

Name:

Phone:

E-mail Address Please print legibly:

Mailing Address:

City, State ZIP:

Fill out during meeting: Team:

Name:

Phone:

E-mail Address Please print legibly:

Mailing Address:

City, State ZIP:

Fill out during meeting: Team:

Name:

Phone:

E-mail Address Please print legibly:

Mailing Address:

City, State ZIP:

Fill out during meeting: Team:

Name:

Phone:

E-mail Address Please print legibly:

Mailing Address:

City, State ZIP:

Fill out during meeting: Team:

Name:

Phone:

E-mail Address Please print legibly:

Mailing Address:

City, State ZIP:

Fill out during meeting: Team:

‰ Yes ‰ No

‰ Yes ‰ No

‰ Yes ‰ No

‰ Yes ‰ No

‰ Yes ‰ No

‰ Yes ‰ No

‰ Yes ‰ No

Team leader: After the party, enter your information at: www.moveonpac.org/team/movienight/reporting.html. Petitioning location:____________________________ time:__________ other team leader names: ____________________ MoveOn PAC will treat your contact information as private and confidential. We will not provide your contact information to any other organization except MoveOn.org and MoveOn.org Voter Fund unless you specifically authorize us. MoveOn PAC will send you updates by e-mail. We will do our best to respect your time and attention. You can remove yourself from the mailing list at any time. We may also contact you by phone to coordinate your participation in MoveOn events.