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| Street Address: |
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| City, State & Zip: |
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| Email Address*: |
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| Phone Cell/Home*: |
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| My Area(s) of Interest Is/Are: |
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| I Prefer to: Table, Distribute Leaflets, Demonstrate Peacefully, Letter Write, Research, Fund Raise, Monitor Animal Cruelty Court Cases, Foster Animals, Transport Animals: |
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| Days and Times Available: |
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How did you hear about CUFA?: Bumper Sticker, Referral by: , Website Link at www. , Event Name & Date: |
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