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Become a Congressional District Coordinator

Please fill out the brief form below to sign up as a Congressional District Coordinator (CDC) with the US Campaign to End the Israeli Occupation.

Read about the roles and responsibilities of CDC's by clicking here.

* First Name
* Last Name
Organization
Title/Position
* E-mail
* Mailing Address
* City
* State
* Zip
* Phone Number
Web Page
Are you a member of the US Campaign?
What is your Congressional district (state and number please)?
* Can we post your name and email address on the US Campaign web site?

List any organizational affiliation/s.
Are these organizations affiliated with the US Campaign?

List any advocacy/organizing experience.
Comments
First Name
* Required Field