The Campaign to Label Genetically Engineered Foods

Activist Contact Form

Use this form to register to be listed on The Campaign's web site as an Activist Contact in your state. If you wish to be listed, you should be actively involved in recruiting others in the effort to label genetically engineered foods.

Fill in your contact information, and click the submit button. In most cases your information will be reviewed and posted on our web site within one week.

Note: The Campaign reserves the right to refuse to list anyone. Please read the disclosure information at the bottom of this page before submitting this form.

Activist Contact Information

Your Name:
Your City & State:
Your Telephone:
Your E-mail:

If you are affiliated with another activist organization as a contact or in a leadership role, please indicate the organization's name and whether or not you want that affiliation listed:

To protect your privacy, we only list your name, locality, telephone and e-mail address. We do not list your street address. However, for our internal records, please include your mailing address:

Street or PO Box:
City, State, & Zip

While it is not required, we strongly encourage activist contacts to join The Campaign to Label Genetically Engineered Foods as a member in order to stay informed about the latest news and developments. Active Membership is only $12.00. Are you currently a member of The Campaign:
Yes No Will Join Soon

Please list any other comments or details about yourself you would like to share with the management of The Campaign to Label Genetically Engineered Foods:

PLEASE READ THE FOLLOWING DISCLAIMER BEFORE SUBMITTING YOUR ACTIVIST CONTACT LISTING:

The Campaign to Label Genetically Engineered Foods lists the following disclaimer on the state Activities & Contacts web pages:

"Activist Contacts are not employees of The Campaign to Label Genetically Engineered Foods. They do not necessarily represent the views or opinions of the management of The Campaign. These contacts are provided to facilitate networking of activists in various cities and communities around the United States. "

By submitting your activist contact listing on this form you understand that you are not an employee or agent of The Campaign to Label Genetically Engineered Foods. Therefore you agree not to represent yourself to the public or media as an official representative of The Campaign's management, but as an independent activist contact in your state and locality.

Please click the button below to submit this form.

Thank you for your activism!