Date: Thu, 24 Aug 1995 10:15:29 -0400 (EDT)
From: And Justice for All <justice@clark.net>
Subject: Membership Registration Form



     Membership Registration Form
     And Justice for All
     
     ___ $20 - Regular Membership
     
     ___  $5 - Limited Income/Student Membership
     
     $______ - Additional Contribution
     
     $______ - TOTAL ENCLOSED
     
     
     Name: ____________________________________________
     
     Address: _________________________________________
     
     City: _______________ State: ______ Zip: _________
     
     Work Phone: ____________________
     
     Home Phone: ____________________
     
     Fax Phone:  ____________________
     
     Internet:   ______________________________________
     
     WWW Page:   ______________________________________
     
     Are you currently enrolled as a student? _________
     
     If yes, where? ___________________________________
     
     We are constantly looking for people who might be
     interested in supporting our efforts (both financially
     and politically).  If you know of someone you think
     might be interested, please give us an address and we
     would be happy to get in touch.
     
     Name: ____________________________________________
     
     Address: _________________________________________
     
     City: _______________ State: ______ Zip: _________
     
     Internet: ________________________________________
     
     Checks (and money orders) should be made payable to 
     And Justice for All; they should be mailed to us at the
     following address:
     
     P.O. Box 53079
     Washington, DC  20009
     
     Contributions to And Justice for All are not tax
     deductible and may be used to advocate the election or
     defeat of candidates for federal office.