To sign the Peace Pledge, please complete the following:
Name:
Sex: Male Female
Birthdate:
Occupation:
Address:
Phone:
Fax:
E-mail:
Please answer the following questions:
Q1. Would you mind if your name appears on the list of the signees? Yes No
Q2. How did you know Peace Pledge and our activities? friend acquaintance media internet other
Q3. Please comment on our activities. We would also like to hear why you decided to sign! Thank you. With your input we can continue to improve our initiatives and activities!