Join PETA's Activist Network

PETA’s Activist Network is a computerised listing of individuals and groups that are actively promoting animal rights.

Please take a moment to fill out the questionnaire below and return it to us. This will enable us to inform you, via e-mail, of upcoming events in your area, new literature, urgent action alerts and breaking news. PETA’s Activist Network is crucial to our work for animals. We value your involvement and look forward to working with you. Please contact PETA if you have any questions.

We will, in turn, send your name to others who join the Activist Network. (Please be aware that although we cannot vouch for everyone who receives these lists, we feel that it is more important to support new activists by providing them with contact names than to refrain from doing so out of fear of the rare individual who may not be genuine.)

Thank you for all that you do for animals. Together, we – and animals – are winning.

Please choose	** please choose ** New Member Existing member update
Region	** please choose ** Asia-Pacific Canada Central and South America Europe Germany India Middle-East United States Other
Organisation (if applicable)
First Name
Last Name
Address 1
Address 2
City
State/Province	** please choose ** AB AE AK AL APO AR AZ BC CA CO CT DC DE FL FM FPO GA GU HI IA ID IL IN KS KY LA MA MB MD ME MH MI MN MO MP MS MT NB NC ND NE NH NJ NL NM NS NV NY OH OK ON OR PA PE PR QC RI SC SD SK TN TX UT VA VT WA WI WV WY YK
Country	** please choose ** United States Australia Canada France Indonesia Netherlands Philippines United Kingdom Afghanistan Albania Algeria Andorra Angola Antigua Argentina Armenia Austria Azerbaijan Azores Bahamas Bahrain Balearic Islands Bangladesh Barbados Barbuda Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canary Island Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo (Brazzaville) Congo, Democratic Republic Corsica Costa Rica Côte d'lvoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor (Timor Timur) Ecuador Egypt El Salvador England Equatorial Guinea Eritrea Estonia Ethiopia Faroe Islands Fiji Finland Gabon Gambia, The Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Herzegovina Honduras Hong Kong SAR Hungary Iceland India Iran Iraq Ireland Ireland Northern Irish Republic Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kirghizstan Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Lagos Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau SAR Macedonia Madagascar Madeira Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Morocco Mozambique Myanmar Namibia Nauru Nepal New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Samoa San Marino Sao Tome and Principe Saudi Arabia Scotland Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Spitzbergen Sri Lanka St. Vincent and Grenadines Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Tibet Tobago Togo Tonga Trinidad Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wales Western Sahara Yemen Zambia Zimbabwe
Zip/Postal Code
Fax
Country Code
E-Mail
Nearest Metropolitan Area
Home Telephone (with area code)
Work Telephone (with area code)
Cellular/Mobile Telephone (with area code)
Text Number/Address
Provider
	** please choose ** USA:AT&T USA:Cingular USA:Cingular-Bellsouth USA:Cingular-Pacific Bell USA:Dobson Cellular USA:Leap Wireless USA:Nextel USA:Sprint PCS USA:T-Mobile USA:T-Mobile (Contract Subscribers) USA:T-Mobile: PCS One USA:T-Mobile: Powertel USA:US Cellular USA:Verizon Wireless USA:Virgin Mobile Ireland:Eircell (Vodafone) Ireland:Meteor Ireland:O2 (Esat Digifone) UK:Hutchison 3G UK Ltd UK:O2 (BT Cellnet) UK:Orange UK:T-Mobile (One-2-One,Virgin,C&W) UK:Tesco (Virtual for O2) UK:Unallocated Prefixes UK:Vodafone India: Bharti India: BPL Mobile India: Escotel Mobile India: Hexacom India: Hutchinson East India: Hutchinson Max India: RPG Cellular India: Spice Commns
How would you like to be listed?
	** please choose ** As an individual As the primary contact for a group
If you are with a group, what is the name of the group?
Are you a student?
	** please choose ** Yes, secondary Yes, university Non
Which of the following are your/your group's primary interests? (check all that apply.)
	Animals in Entertainment
	Animal Testing
	Fishing
	General Animal Rights
	Skins (Wool, Fur, Leather)
	Vegetarianism
	Wool
Other (please specify.)
Are you interested in assisting with the following current PETA campaigns? (Check all that apply.)
	KFC Cruelty
	Wool
If not, would you like to be contacted to attend organised demos, protests, tabling events, etc.?
	** please choose ** Yes No
Are you available during business hours?
	** please choose ** Yes No
Could you organise demonstrations and protests (with our assistance)?
	** please choose ** Yes No
Would you be willing to serve as media spokesperson at a protest or event (we can supply information and facts to help with media interviews)?
	** please choose ** Yes No
Which of the following languages do you speak fluently?
	Arabic
	Bengali
	Chinese-Cantonese
	Chinese-Mandarin
	Dutch
	English
	French
	German
	Hindi
	Italian
	Japanese
	Korean
	Polish
	Portuguese
	Russian
	Spanish
Other (please specify.)
Would you be able to professionally translate documents?
	** please choose ** Yes No
Do you have a special area of expertise or talent (e.g., rock climbing, art, etc.)? If so, please indicate
Can you provide a home for animals from farms?
	** please choose ** Yes No
	I am at least 13 years old.

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