VADP Organization Membership Form, 2015 March 9

VIRGINIANS FOR

k / ALTERNATIVES

TO THE DEATH PENALTY

Organization Membership

Please add our organization to the membership list
of Virginians for Alternatives to the Death Penalty.
Let us know how we can help on this important
public policy issue.

Please Write Clearly

ORGANIZATION NAME

ADDRESS
CITY STATE ZIP
OFFICE PHONE OFFICE FAX

ORGANIZATIONAL CONTACT PERSON FOR VADP:

NAME TITLE

ADDRESS

CITY STATE ZIP
DAY PHONE EVENING PHONE

E-MAIL


MEMBERSHIP DONATION:

0 $250

0 $500 0 $1,000 0 Other:

Virginians for Alternatives to the Death
Penalty
P.O. Box 12222 * Richmond, VA 23241 * (434) 960-7779