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Please print out and return completed form to:
The U.S. Tibet Committee | 241 East 32nd Street | New York, NY 10016 | USA
tel 212.481.3569 | fax 212.779.9245 (attn:ustc)
Name:

Address:

Telephone:

E-mail:

By becoming a member of the U.S. Tibet Committee, your support allows us to broaden public concern for Tibet, and to inspire that concern into action.

__ Yes, I would like to help Tibet! Here is my donation of:

__ $35 (membership fee)   __ $65   __ $100   __ $150   __ other: _______

* Please make all tax-deductible contributions payable to the U.S. Tibet Committee.

__ I cannot donate at this time, but would like to be on your mailing list.

ustc merchandise: I would like to order ___ Tibetan flags ($20 each)
* Please make all tax-deductible contributions payable to the U.S. Tibet Committee.

__ I am interested in volunteering in the following areas. Please contact me so I can find out more.

     __ fundraising/special events

     __ attending protests/leafleting

     __ public relations/media

     __ mailings/clerical tasks

     __ graphic design

     __ starting a local chapter

     __ other:

__ join the USTC Urgent Action E-mail Alert Network

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