Participant Sign-Up Form
Let us know how you will Meet Us on the Street for International Anti-Street Harassment Week 2012!
My Name: *
Your answer
My E-mail Address: *
Your answer
The City/Town Where I Live: *
(If it's not a major city, please also add the state, province, and/or country)
Your answer
I pledge to do the following Personal Level options during the week of March 18-24, 2012:
(Check all that apply)
I will lead the following Collective Action & provide details for the event on the map: https://meetusonthestreet12.crowdmap.com
(If you are not organizing anything, you can skip the question)
I'm interested in being a participant of Collective Action
(If you say yes, we will connect you to someone in your area)
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service