Become an Affiliate webform

fill this out to become an affiliate.

Where is your affiliate located?
How would you describe the community/area your affiliate would represent/organize with?
You can include: race, economic status, national origin, immigration status, sexual preference, gender identity, and age
What are the primary challenges/issues in your community? (Examples: lack of reproduction education, anti-welfare and immigration policies, lack of affordable housing/no tenant rights policies; limited healthcare access; poor working/labor conditions; increased law enforcement violence; high rates of intimate partner/sexual abuse; high rate of violence against LBGTTSQ communities of color and limited resources, lack of leadership development for youth, etc)
Where possible, specify suggested activities
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