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Yes, I/We want to be listed as a supporter of “Arkansas Community Statement in Support of Comprehensive Immigration Reform.”  

Please list me/us as:

 
(your name or organization name, or both if appropriate)

My Contact Information Is:
Name:  
Organization:  
Address:  
City:  
State:  
Phone:  
Fax:
Email Address:  

We are continuing to gather signatures in support of the statement. If you have any questions or concerns please contact:

Ruth Shepherd
Just Communities of Central Arkansas
1400 W. Markham, Ste. 405
Little Rock, AR 72201
Or by email: rshepherd@justcommunities.org
FAX: 501-372-5120

If you know of other individuals or organizations who might want to join us, feel free to forward this form to them.

    1400 West Markham, Suite 405
Little Rock, Arkansas 72201
501-372-5129