Pesticide
Free Zone Campaign
(Print
out and mail in with check or money order)
Name __________________________________________ Phone # ________________
(Your name will not be shared with other organizations
& no additional contact unless you request to participate)
Address ________________________________________ Fax # __________________
______________________________________________________________________
e-mail __________________________________________________________
q I
want to get involved (we will help
you find a support group)
|
School pesticide issues |
q |
I am interested in agricultural spray issues |
q |
|
Urban spray issues |
q |
I am willing to become a fund raiser |
q |
| I am willing to write letters | q | I am willing to send letters to the editor | q |
|
I can best help in the following way: _________________________________________________________ |
I
wish to order the following items:
| Item |
number |
suggested donation/ item |
postage |
total donation |
|
Pesticide Free Zone 8" metal yard sign (English ____ Spanish _____) |
_____ | $15.00 or more= |
included | __________ |
| Pesticide Free Zone 4 1/2" Bumper Sticker | ______ |
$1.00 or more= |
$0.42 or 1 stamp |
___________ |
| Pesticide Free Zone 2 3/4" Stickers | ______ |
$1.00 / 4 or more= |
$0.42 or 1 stamp |
___________ |
| Pesticide Free Zone white cotton "T" shirts (size_____) | ______ |
$18.00 (child)= $20.00 (adult)= additional donation welcomed |
$1.50 each or $4.60 Priority service |
___________ |
Please
make donation checks payable to: Pesticide Free Zone Campaign
Mail to: Pesticide Free Zone Campaign
PO Box 824, Kentfield, CA 94914-0824
Any questions---call us at 888/590-3993 or
415/459-1391
For group purchases we can make arrangements for reduced prices and allow
you to develop your own pledge program.