Picture Your Green New Future Art Build Request Form

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Mothers Out Front - New River Valley (MOF NRV) would like to offer Virginia residents an opportunity to advocate to their state representatives for the VA Green New Deal through a creative youth art build. We are asking mamas, their kids and anyone that is passionate about a greener future to create an inspiring photo to send to their representatives that depicts what they envision or picture for THEIR "Green New Future". This can be done with any sort of media and art can be mailed or photos can be emailed to your specific representative. MOF NRV will provide the basic materials below upon request first come first serve while supplies last. Thank you for your support. Please select from the options below ALL that you would like to receive by mail.

Name (First, Last) *

Mailing Address (Please include street address, city/town, state and zip code) *

I would like to receive the following Art Build materials (check all that you wish to receive by mail (free of charge) *

Eco-friendly art kit (recycled drawing paper and crayons)

Envelope to send art

Postage

Required

I prefer to receive... *

Pre-addressed envelope to my state delegate and postage

Envelope and postage without the state delegate's address (I prefer to select which representative to send the art)

No envelope or postage, I will email a photo or send it myself.

Required

Please consent below *

I consent to receive by mail the items selected above.

Required

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