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UUADP
29 Westchester Court,
Little Rock, AR 72223-4323

I would like to stand with Unitarian Universalists for Alternatives to the Death Penalty. (Social Action Committees should form chapters, and name a contact person who will help to keep their committee and congregation informed on this issue.)

(PLEASE PRINT)

Name ___________________________________________________
Address_________________________________________________
________________________________________________________
________________________________________________________
E-mail _________________________________________________
Phone __________________________________________________
Fax ____________________________________________________
UU Congregation and Location______________________________
________________________________________________________
Please set membership dues based upon your ability to pay:
____$25 ____$35 ____$50 ____$100 ____other

UUADP Items:
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T-Shirt____________
Polo Shirt____________
Buttons______
Bumper Stickers______
Donation Enclosed______

UUADP is a 501(c)(3) non-profit corporation. Your donations are tax deductible. Thank you for your contribution!