Social Justice Activity Record

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Social Justice Activity Record

This form is for members of UUBN to report social justice activities they are involved in.

Examples: Attended an educational event or rally, read a book, filled out a witness slip, contacted my legislator, etc.

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* Indicates required question

What is your name? *

Your answer

Is this a future activity or something you have already done? *

This is a planned activity in the future

This is an account of something I have already done

What group sponsored this activity? *

Your answer

Tell us about the activity: *

Your answer

Please indicate the date the of the activity: *

MM

/

DD

/

YYYY

Any additional comments?

Your answer

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