SUPPORT THE GLOBAL NETWORK

Global Network Membership Form 2011

* Membership in the Global Network Against Weapons & Nuclear Power in Space is open to all organizations and individuals.

* Please add (Organization/Individual) _______________________________________________to the Global Network membership list.

* Enclosed is our annual dues for 2011 in the amount of __________________ (pay what you can best afford on a sliding scale between $10 - $100).

* Donations to the Global Network are tax deductible.

(One easy way to donate is using the internet. Go to our web site at http://www.space4peace.org/ and look for the Donate Now! button and contribute via your credit card. This is a secure process.)

Name _____________________________

Address ___________________________

City_______________________________

State __________Postal Code ___________

Country___________________________

Phone ____________________________

E-Mail ____________________________

Thank you for your support. (If you have already recently donated for 2011 we thank you very much.)

Global Network Against Weapons & Nuclear Power in Space
PO Box 652
Brunswick, ME 04011
(207) 443-9502
http://www.space4peace.org/

globalnet@mindspring.com