Endorsement Form - Child Marriage Prevention Act
Please sign on below. This list will be shared with Senator Durbin's office and published on Tahirih's public facing webpage about this bill. 

Bill text can be found here and more background information about the legislation - including the list of currently endorsing organizations and individuals - can be found here
Sign in to Google to save your progress. Learn more
Email Address *
Name *
Organization Name (for those not representing an organization please put N/A)
*
If signing on in your individual capacity, please indicate here if you identify as a survivor.
Clear selection
Do you have authority to endorse legislation on behalf of your organization? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report