I support the goal of the People's Campaign for the Constitution: To restore constitutional rights, checks and balances, and the rule of law, which have been violated under the guise of a permanent "War on Terror." I pledge to join with others to hold elected representatives and candidates for public office to the oaths they have made or must make: to protect and defend the U.S. Constitution.

   First Name:

   Last Name:

   E-mail:

   Organization:

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   Address:

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   State: Select . . . AA AE AK AL AP AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY

   ZIP Code:

I certify that I am fully authorized to make this pledge on behalf of the organization listed below.

We support the goal of the People's Campaign for the Constitution: To restore constitutional rights, checks and balances, and the rule of law, which have been violated under the guise of a permanent "War on Terror." We pledge to join with others in our community to hold elected representatives and candidates for public office to the oaths they have made or must make: to protect and defend the U.S. Constitution.

   What commitment(s) can your organization make to the PCC right now?
       Announce this pledge to our constituents
       Place a button or link to the PCC on our website or blog
       Start a local PCC coalition or join an existing one
      Other:

   What financial commitment, if any, can your organization make to this campaign?
       Our organization will commit funds to support staff and resources for the campaign
      Other:

Information provided here WILL be displayed publicly on the BORDC website.

   Organization Name:

   E-mail:

   Website URL:

   First Name:

   Last Name:

   Telephone:

   Fax:

   Address:

   City/Town:

   State: Select . . . AA AE AK AL AP AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY

   ZIP Code:

This information will NOT be disclosed publicly. It is only for internal use by the BORDC.

   First Name:

   Last Name:

   E-mail:

   Title:

   Telephone:

   Fax:

   Address:

   City/Town:

   State: Select . . . AA AE AK AL AP AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY

   ZIP Code:

This information will NOT be disclosed publicly. It is optional, but helpful to us.

   Approximate number of constituents/members:

   Operational scope: Select... Local Statewide Regional National International

   Year established:

   Primary focus: Select... Policy Advocacy Lobbying Political Party Grassroots Organizing

   Approximate annual budget: Select... less than $10K $10K - 100K $100K - 250K $250K - 1M $1M - 5M more than $5M

   How do you disseminate information to your constituents/members?
       E-mail
       Snail-mail
       Telephone Tree
       Blog
       Public Access TV
       Commercial TV
       DVD Productions
       Public Radio
       Commercial Radio
       Flyering
       Print Ads
      Other: