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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:
| Item | Size | Qty | ||
| 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!