Public Transportation

Sample Coalition Enrollment Form

You can use this form to sign up members for your coalition.

Yes, my organization strongly supports the viability and expansion of public transportation in our community! We support increased funding for public transportation and would like to participate in the coalition’s efforts. Please add our organization’s name to the [insert name of coalition]’s membership list. We understand that there is no financial obligation connected to our enrollment and our participation is voluntary.

Organization:__________________________

Contact Person / Title:__________________________

Signature:__________________________

Street Address:__________________________

City / State / ZIP:__________________________

Phone Number:__________________________

Fax Number:__________________________

E-mail:__________________________

Preferred method of communication:__________________________

Please indicate the activities in which you or your organization is most interested:

__ Communicating with local officials (through meetings, letters, and telephone calls)

__ Communicating with the media (through interviews, meetings and briefings)

__ Communicating with the public (through speeches or presentations to local groups)

__ Participating in public events, such as government hearings and press conferences

__ Providing the following in-kind contributions or support:__________________________

__ Other activities:__________________________

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