Short Form - The info at top of page is all we need to have you sign up to become '1 of 52' in your state.
Today's Date: _______________
[ ] Yes, I would like to participate in the 1 of 52 Hunger
Network!
Your name: ______________________________________________________________________
(Optional signature: _______________________________________________________________
)
Name of company / organization/ artist / group: __________________________________________
Mailing address: __________________________________________________________________
Phone: __________________________________________________________________________
Fax: ____________________________________________________________________________
Email: ___________________________________________________________________________
Web sites: ________________________________________________________________________
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Describe type of actions to be taken (Can describe in general or specific terms. More details can follow): _________________________________________________________________________________
_________________________________________________________________________________
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(Short Form Complete.) (Below: More/Optional info if available or known.)
The info below is not required to join up at this time, details can follow - info is always welcome before and after your actions for pre and post publcity.
Alternate contact: ____________________________________________________________________
Agency / Company: __________________________________________________________________
Management: _______________________________________________________________________
Phone/Fax/Email/Web site: ____________________________________________________________
__________________________________________________________________________________
Location of event / action: ______________________________________________________________
Tickets available in advance? _______ Prices $______________________________________________
Phone number and address of venue: _____________________________________________________
Contact person at venue: _______________________________________________________________
Event dates / times / details: ____________________________________________________________
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Artists / speakers on bill in order of appearance: _____________________________________________
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Media contacts: ______________________________________________________________________
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Other details on actions / comments / activities: ______________________________________________
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Please print this information form, copy it,
and share it with others who might like to join the network.