JOINING STONEWALL AKRON
Mail-In Membership Form
___ New Membership ___ Renewal
___ Change of Information ___ Send Me SA's Newsletter
Name    _____________________________
Address    _____________________________
City    _____________________________
State    _____________________________
Zip    _____________________________
Home Phone    _____________________________
Fax    _____________________________
Work Phone    _____________________________
Email    _____________________________

___ Yes ___ No Please check if you require confidentiality.
We will send all mailings in sealed envelopes
and not leave any phone / fax messages.

___ Single $15 ___ Couple $25 ___ Business/Org. $35
___ Donation $___________ for _____________________________

Particular area(s) of interest or expertise: Please check all that apply.
Can we call on you when the need arises? You don't have to be out
or to get outed to help us with some of these activities.
___ Can send out email messages and alerts
___ Can send out press releases if provided addresses and information
___ Conduct voter registration at ___events ___bars ___public places
___ Can do literature drops or "bar blitzes"
(bar hop and inform patrons of upcoming events or on issues...)
___ Send me email information and action alerts
___ Have grant writing experience I can offer
___ Can sit at a fundraising table and sell goods for Stonewall
___ Lobby state or federal legislators with calls, mail or faxes
___ Attend a rally or political action
___ Assist preparing/assembling newsletter or mailings
(at this time usually done at the Roseto Club in Akron)
___ Can make phone calls in my non LD area to educate/inform folks
___ Call me whenever I might be able to help out


Stonewall Akron Thanks You Very Much!

      Stonewall Akron
      PO BOX 3216
      AKRON, OH 44309-3216