NAME__________________________________________________________

RELIGIOUS COMMUNITY_________________________________________

ADDRESS_______________________________________________________

TELEPHONE NUMBER___________________________________________

E-MAIL ADDRESS________________________________________________


Please check all that apply:

___Contact me about providing o speaker to our community.

___Contact me about participation in your work.

___Send me further information on your work.

___I am interested in serving on the religious organizing committee.

Complete form and send to:

Illinois Coalition to Abolish the Death Penalty
180 N. Michigan Avenue, Suite 2300, Chicago, IL 60601
312/849-2279, www.icadp.org