Sign the Organizational Petition Form

By filling out and submitting this form, you are signing your organization’s support of the Universal Declaration on Circumcision, Excision and Incision and The Ashley Montagu Resolution. Only fields you have selected as being "Public" will appear to the public on the website. Fields marked "Private" will only be shown to officials during the process of officially submitting the petition sigatures.

If you mark your organization name as “Private,” your organization’s signature will not appear to the public on our website, but will be maintained on the official list of signatures.

If you mark any field private, at no time will we give or sell the information in that field, be it your email address or other information, to any other person or organization for purposes other than promoting genital integrity. If you make any field public, it will be available to anyone who visits your signature on the site.

In order to authenticate the signature, for the protection of the organization and its members, we require in addition to filling out the web form, that a letter of authorization be sent to:

Van Lewis, Site Administrator
P.O. Box 323
Panacea, Florida 32346

signed by the president, secretary, or chief executive officer of the organization, or that one of them communicate by email with the Site Administrator so that we may be assured that the organization’s endorsement is authentic.

Required fields are in red and marked with a *.

Organization Name^*:	Public Private
Email Address^*:	Public Private
Confirm Email Address^*:
Address^*:	Public Private
Address (Second Line):	Public Private
City^*:	Public Private
State / Province^*:	Public Private	If you do not live in the United States, Canada, or Australia, please enter your state or province: (We would appreciate it if we can publish your state or province publicly, but if that is not possible, click “Private” and your request will be honored.)
Postal / Zip Code^*:	Public Private
Country^*:	Public Private	(We would appreciate it if we can publish your country publicly, but if that is not possible, click “Private” and your request will be honored.)
Phone Number:	Public Private
Website URL(s):	Public Private
	Public Private
Organization Type^*:	Public Private	Line of Business:
Names of officers approving this endorsement (please list all, but one is required):	Public Private	Chair of the Board: President: Vice President: Secretary: Treasurer:
Your Organization’s official position on Genital Integrity Subjects:	Public Private
By filling out and submitting this form, you are signing your organization’s support of the Universal Declaration on Circumcision, Excision and Incision and The Ashley Montagu Resolution. Only fields you have selected as being "Public" will appear to the public on the website. Fields marked "Private" will only be shown to officials during the process of officially submitting the petition sigatures. If you mark your organization name as "Private," your signature will not appear to the public on our website, but will be maintained on the official list of signatures. If you mark any field private, at no time will we give or sell the information in that field, be it your email address or other information, to any other person or organization for purposes other than promoting genital integrity. If you make any field public, it will be available to anyone who visits your signature on the site.

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