Week of Action Group Signup

Local Group Action Signup

#WeekofAction
Group Name *
Group Website
There will be a place to share the url for the event below
Social Media Link
Facebook, Twitter, or Instagram link to follow for updates
Email *
This email will not be shared publicly
Phone Number (Not Shared)

Area Code Phone Number
City *
Event is remote but helps to locate local groups
State *
Zip Code *
Event Name *
Date *

Month Day Year
Date
Event Description
Event Updates
How do people stay up to date about the event? FB URL, Website, Etc
Event Image or Logo
Would you be interested in talking to press about your group's Week of Action participation if the opportunity arose? *

Yes No

Local Group Action Signup