Mississippi Parents for Vaccine Rights Member Form
MS Parents for Vaccine Rights. Member Form. All Members.
Name *
Email Address *
Facebook Name *
Cell Phone Number *
We will be sending out text alerts/calls to action.
Do you give permission for us to send you text alerts? *
Mailing Address *
We need this to send out information and literature pertaining to our cause.
Your County *
(Enter N/A if not in MS)
Who is your House Representative? *
You can find this info here: http://openstates.org/ (Enter N/A if not in MS)
What House District are you registered to vote? (This will be a number) *
Find Here: http://openstates.org/ (Enter N/A if not in MS)
Who is your Senate Representative? *
You can find this info here: http://openstates.org/ (Enter N/A if not in MS)
What Senate District are you registered to vote? (This will be a number) *
Find Here: http://openstates.org/ (Enter N/A if not in MS)
Have you reached out to your legislators?
Please Explain.
Please share any contact info that you have for your legislators.
Have you joined our main group page?
Have you "liked" our open community page?
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Are you a member of your regional group? Please mark which group you are in. *
You should only be a member of ONE regional group. If you are not sure which group you belong in, please pm an admin.
Have you been to our MPVR blog? You will find a lot of helpful info here, including our talking points to share with legislators.
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Do you have any special talent, work experience, etc that you feel like would help us in our fight to gain parental rights in MS?
Would you be able to make a trip to the capital in Jackson on our lobbying days?
We will be making trips January-March 2016. Dates will be shared in the group. We plan on starting a car pool and sharing expenses.
Do you understand that our group is for Parental Rights?
We have members in our group that fully vaccinate, selectively vaccinate, vaccinate on a delayed schedule, or do not vaccinate at all. We ask that all members are respectful of others' decisions.
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Any additional questions or concerns?
Do you have a personal vaccine injury story that you would like to share for our blog?
Do you agree to follow the rules of this group? We all come from different backgrounds and have different stories. We have different stances on many issues but we are all aligned in this fight.
Please check off the ones that you have agreed to. Please read through them carefully. Remember, the admins of this group are not paid but are VOLUNTEERING THEIR VALUABLE TIME. If something is missed that needs to be addressed, kindly let an admin know privately. An offensive post/comment by one or two members doesn't reflect the entire one thousand plus members. When we each decide to take our toys and go home because we don't like what so-and-so said, WE LOSE. Thick skin is a requirement to winning in politics.
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