Advocacy Declaration Signatory Form
Complete this form to officially sign and authorize your agreement to the advocacy declaration on behalf of your organization or cause.
Full Name of Signatory
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Organization or Cause Name
*
Signatory’s Position/Title
*
Advocacy Declaration Title
*
Declaration Statement
*
Do you have authorization to sign on behalf of the organization or cause?
*
Yes
No
Date of Signing
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
By signing below, I confirm that all information is accurate and I agree to the advocacy declaration.
*
Submit Declaration
Submit Declaration
Should be Empty: