GABNet Membership Application Form

YOUR $10 CAN HELP END THE TRAFFICKING OF FILIPINO WOMEN AND CHILDREN. Support the Purple Rose Campaign

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G A B R I E L A N E T W O R K U S A
A Philippine-US Women's Solidarity Mass Organization, est. 1989

GETTING INVOLVED

GABNET MEMBERSHIP. Thank you for your interest in becoming a Member of GABNet. Please complete and submit the form below. You'll be automatically signed-up for our news/action alert list.


	*GABNET MEMBERSHIP APPLICATION FORM (indicates required fields)**

	YOUR NAME AND CONTACT INFORMATION
	*first name:
	*last name:
	address:
	*city:
	*state:
	zip:
	*email:
	home phone or land line:
	mobile:

	TELL US ABOUT YOURSELF
	ethnicity or native country:
	date of birth:
	occupation or area of specialization:
	educational background:
	school and/or organizational affiliations (if any):
	areas of interest (please check all that apply):	anti-trafficking
		human rights
		immigrant women's rights
		LGBTQQI caucus
		militarism
		violence against women
		women's health and reproductive rights
		young women's issues
		cultural projects
		fundraising
		community organizing
		mass actions
		legal advocacy
		direct service for women
		other (please specify below)

	skills (e.g. computer, visual arts, graphics, media production, writing, etc.):
	language/s (please indicate level of fluency--i.e. understand, speak, read, write):
	how did you hear about GABNet:	friend online search at an event university other (please explain below)
	why do you want to join GABNet:
	*which GABNet Chapter are you interested in joining:	Chicago Irvine Los Angeles New Jersey New York Portland OR Pullman WA San Diego San Francisco Bay Area Seattle Washington DC
	additional comments:

GETTING INVOLVED

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Last updated: 14-Feb-2007 . Comments, suggestions about this website? Email our webms Lorena.

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