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Extinction Rebellion Sign-up Form
(If you're not based in the UK- please fill in the form on the international website-https://xrebellion.org/)
Email address *
Name *
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Postcode (First three/four characters)
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Phone (please include a space)
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In principle, would you be willing to:
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No
Co-facilitate a workshop/training
Help with the campaign organisation
Get arrested
Go to prison for a short time
Take a support role
Any comments you wish to say about your responses above
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Are you involved in any networks or organisations?
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Which working group are you interested in? More info on working groups here- https://goo.gl/mfHZPV
If you wish to help with organising, do you have any particular experience or skills?
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Would you be interested in dedicating more time to Extinction Rebellion?
Comments/Feedback
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Affinity Group Name (If applicable)
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Which event did you attend? (If applicable)
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