6 FEET IN THE STREET REGISTRATION
"Join the Movement in the Street!"
Local Movement With Worldwide Potential
Name: First and Last
What is your cell phone number (not required but will provide for faster response)
What is your mailing address (make sure to include Zip Code!)
Which best describes you
Governmental Worker (mayor, city official, politician)
Member of the press (television/radio personality, reporter etc.)
What best describes you?
Born before 1964
Born between 1965 - 1980
Born between 1981 - 1996
Born between 1997 - 2012
What city would you like to see a "6 FEET IN THE STREET" event hosted?
Would you be willing to help host a "6 FEET IN THE STREET" event in that city?
May we have one of our representatives contact you concerning your interests in "6 FEET IN THE STREET?"
How did you hear about "6 FEET IN THE STREET?
Send me a copy of my responses.
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