What types of activities are you willing to take part in?

Contact your friends about the campaign
Reaching out to your neighbors about the campaign
Forwarding an email to your networks
Writing to policy makers
Attending an event
Acting as a spokesperson (for the press, at an event, etc.)
Phone banking
Handing out literature
Door knocking
All of the above

Contribute to the NCE ( Please specify amount ) $

What types of issues are you interested in getting involved in?

Unpaid wages
Unemployment insurance
Retirement
Health insurance
All of the above
Other, (Please specify)

Tell us a little more about yourself...

Member ID # < If you do not have a member ID, leave blank

* First name

* Last name

Street address

Addrss line 2 ( Apt # )

City State Zip

* Email address

* Daytime phone number AREA CODE FIRST

Industry

Occupation