OUTfront! Lesbian, Gay, Bisexual & Transgender Human Rights


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Join OUTfront!

To Join AIUSA's OUTfront Network, simply print out this page and send it with your AIUSA membership dues to:
Amnesty International USA OUTfront
NLGCW
5 Penn Plaza 14th Floor
New York, NY 10001
Fax: (212) 627-1451
I would like to become a member of Amnesty International and OUTfront.
Enclosed are my membership dues:

___ $25 Individual      ___ $15 Student / Senior / Limited Income

___ I am currently a member of AIUSA and would like to become a member of OUTfront.
___My AIUSA Student or Local Group would like to sign up for the OUTfront Network.
___I would like to join the OUTfront e-action network.

I understand that AIUSA depends on the generosity of members. I want to make an additonal contribution. For membership dues and a contribution combined, I am giving:
___ $50     ___ $75      ___ $100     ___ other

Please fill in the following:
Name___________________________________________________
Address______________________________________________________
City______________________________________________________
State & Zip___________________________________________
Phone_________________________________________________________
Email___________________________________________________________
I want to give by:
___ Check (made payable to Amnesty International USA)
___ Visa
___ Mastercard

Card Number__________________________________________
Expiration Date_________________________________________
Signature___________________________________________________________
NLGCW
For more information about Amnesty International's work on behalf of lesbians, gay men, bisexuals and transgender people, contact Michael Heflin or Ariel Herrera at the National Office:

Amnesty International, 5 Penn Plaza 14th Floor, New York, NY, 10001
phone: (212) 807-8400
email: outfront@aiusa.org or through your Local Regional Offices.