Please note that the deadline is April 9!
There are two registration options (please mark "Leafleting Day"):
1. Print this page and mail in with check for $10 ($15 USD for Canada) made out to to Viva!USA, PO Box 4398, Davis, CA 95617.
2. Or submit the form on-line, and you will be taken to a page to donate securely with a credit card.
If you have questions, please e-mail Jack -- firstname.lastname@example.org. Thank you.