I pledge to leaflet a Starbucks store on Valentine's Day!
Please print and use the leaflets at this link
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Name *
Email *
Phone *
Will you be participating in the Valentine's Day info leaflet? *
Starbucks Store Address? *
Street, City, State
If you plan to leaflet at any additional stores in your area, please list the store address(es) below.
If unknown for now, just leave blank.
Are you a member of a labor union or community group that's participating in this solidarity action? If so, please list the group here.
Picket hours
If unknown for now, just leave blank.
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