Walk for Peace 2009: Camp Williams to Fort McCoy Sign-Up

Thank you for signing up to participate in this summer’s Walk for Peace. Please review the Statement of Nonviolence since all walk participants are expected to agree with this commitment to nonviolence during this effort.

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Walk for Peace

Walk for Peace

Please complete this form to indicate that you plan to participate in the Walk for Peace.

First Name *
Last Name *
Street Address
Supplemental Address 1 (Primary)
City *
State *	- select - Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
Zip Code
Phone
Email
	Please provide either your email, phone or mailing address so that we can send you updated information on the Walk for Peace as it becomes available.
Participation Dates *
	Please let us know on which dates you plan to participate in the walk (e.g., August 7, 8 or 9).
Nonviolence Guidelines *	Yes No
	Please indicate whether you agree with the Nonviolence Guidelines established for this action. All participants are expected to act in accordance with these guidelines.
Nonviolence Workshop & Training *	Yes No
	Please indicate if you plan to attend the nonviolence workshop on Saturday, August 8 at 2:00 p.m. in Tomah. Participation is required of any who will engage in nonviolent civil disobedience.
Organization
	Please let us know the name of your organization if your organization plans to become involved in the Walk for Peace.
Comments
	Please let us know of any questions, comments, concerns, etc. via this comment form or via email, info@vcnv.org

Thank you for registering for this year’s Walk for Peace. Organizers of this effort can be reached via email, , or phone: 773-878-3815.