Women's Human Rights

To Join AIUSA's Women's Human Rights Network, simply print out this page and send it with your AIUSA membership dues to:

Amnesty International USA
Women's Human Rights Network
322 Eighth Avenue
New York, NY 10001
Fax: (212) 627-1451

I would like to become a member of Amnesty International and the Women's Human Rights Network. Enclosed are my membership dues:
___ $25 Individual
___ $15 Student/Senior/Limited Income

___ I am currently a member of Amnesty International and would like to become a member of the Women's Human Rights Network.

___ My Amnesty International Student or Local Group would like to sign up for the Women's Human Rights Network.

___ I would like to join the Women's Urgent Action Network and receive appeals on behalf of women in imminent danger of severe human rights abuse.

I understand that Amnesty International 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	__________________________________________
E-Mail	__________________________________________

I want to give by:
___ Check (made payable to Amnesty International USA)
___ Visa
___ Mastercard

Card Number	__________________________________________
Expiration Date	__________________________________________
Signature	__________________________________________

For more information, contact the Women's Human Rights Program
Amnesty International USA, 322 8th Avenue, New York, NY, 10001
phone: (212) 633-4251 or (212) 633-4292
email: sdauer@aiusa.org or znawaz@aiusa.org
or through your Local Regional Offices.