Information Request Form


Please fill out the following information, then check which information you wish to receive. If you do not see what you need, check other and let us know what you need.

Name:

Company Name:

Address:

City/State/Zip:

Phone: (day) (evening)

FAX:

E-Mail:



How would you like to be contacted:
Phone Fax Mail Email
(Note: Not all forms are available through Email)


Select buttons that apply:

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Displaying the Quilt:

Displaying small sections of the International Quilt (less than twelve (12) 12x12 sections)
A Panel Request Form for Educational, Community or Corporate displays will be sent to you. You need to allow 2-3 weeks before your event to ensure availability of Quilt and volunteers. Requests are limited to the New York City area.

Displaying large sections of the International Quilt
(more than twelve (12) 12=x12 sections)
A Display Request Form will be sent to you from The NAMES Project Foundation. (connect to FDN)

World AIDS Day Displays in New York City
If you are interested in using the Quilt in New York City for World AIDS Day, December 1st, a special form will be sent to you. The deadline for submitting requests is ___________.

World AIDS Day Displays outside New York
If you are interested in using the Quilt in New York City for World AIDS Day, December 1st, a special form will be sent to you. The deadline for submitting requests is _____________.

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Newsletter, Membership, Fundraising and Volunteering:

Newsletter
We will send you our next edition of the organization's
newsletter.

Membership
If you wish to become a member of our organization, a membership form will be sent to you. There are three tiers of membership; Associate, Organizational, and Supporting to choose from.

Fundraising & Donations
If you would like to donate funds to help support the local activities of our organization, transport Quilt to schools, or cover the many other expenses to care for the Quilt, a donor form will be sent to you. Your contribution is 100% tax deductible.

Volunteering & Committee Positions
We are always looking for people to help with outreach events such as street fairs and major displays. We also need volunteers who are available during the day and want to go into schools with our High School HIV/AIDS Prevention Program curriculum.

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Other:
Please indicate what we can help you with.





Global Quilt
75 Varick Street, Suite 1404
New York, NY 10013
Phone: (212) 226-2292
eFax: (734) 758-0466
Email:
jbosacki@aol.com