Corvallis SURJ Membership Form
Completing this form registers you as a member of Corvallis SURJ.
Email address *
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
I understand that it strengthens the group to have consistent participation. Thinking about my energy level and the things I have going on in my life I am hereby committing to be an active, participating member of Corvallis SURJ for the next:
Please send me information about:
What ways do you want to help?
If you are part of other local social justice organizations, would you be willing to serve as a liaison from SURJ? Please name the organizations, including your faith community if you wish.
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Any additional comments?
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