Organizational Info:
Organization Type*

Select Organization Type Religious Political Pro-life Church Media Author and Speaker Other

Organization Name*

Postal Address*

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Organizational Contacts:
Email*

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Personal Information
First Name*

Last Name*

Organization Role*

Select Organization Role President Vice President Secretary Owner Manager Pastor Other

I am authorized to submit this form on behalf of this organization

Do you subscribe to Traditional Family Values? Yes No

Will you FIGHT for the US Constitution? Yes No

Details of the Ballot Issue
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Select a Ballot Measure Initiative Proposition Referendum Proposition 1 Other

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