Application for Think Outside the Bomb Conference

Application for
TOTB Regional Grassroots Conference
April 12, 2008
American University, Washington, DC

(If you prefer, you can print out this form, fill it in, and mail it to us at
Nuclear Age Peace Foundation
322 Fourth Street NE
Washington, DC 20002)

Basic Questions:

Complete Name:
Street Address:
City:		State / Province:
Zip / Postal Code:		Country:

Home Phone:		Cell Phone:
Email:		Year of Birth (yyyy)

School/Organization (if Applicable):
Special needs, if any:

Short Answer Questions

What type of involvement, if any, have you had with other nuclear disarmament groups, or related initiatives?

From whom or where did you hear about the "Think Outside the Bomb" conferences?

Will you be traveling from out of town/country in order to attend this conference? If so, from where?

Give us a short personal description as a way for us to get to know you better, (feel free to be creative, but be sure to include name, interests, and educational background).

Will you be eating lunch provided by NAPF on Saturday?

Any questions or additional comments?”

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