To Tell The Truth
And Other
Survivor Events
Form for Listing a Local Event
Revised June 2006, by Frank L. Fitzpatrick

Back to To Tell The Truth home page - OR - Survivor Connections, Inc. (separate web site)


Form For Organizers

Print, fill out, and postal mail this to To Tell the Truth Web Site Coordinators,
c/o Survivor Connections, Inc., 52 Lyndon Rd., Cranston, RI 02905-1121 U.S.A.

Preliminary Info for TTTT site? ____ OR Additional Info for TTTT web site? ____

Leave blank what is unknown, and our web site will show that
"details will follow.
"

Contact name to use (full or first) ________________________________________
AND / OR
Organization name (if any) _____________________________________________

Other contact info to be given out for this To Tell The Truth event
(address, and/or email, and/or phone, and/or Web site, and/or PO box

________________________________________________________________

________________________________________________________________

________________________________________________________________
Who may attend (survivors, survivors and their supporters, and /or helping professionals,

or the general public, (news media invited or not invited to the event) ___________________

Fee to be charged ("0" if none). Leave blank if unknown ______________

Exact date & times - OR just month if not yet decided ______________________________

Type of event (rally, march, support group forming, etc.) _______________________________

Details __________________________________________ (Attach page(s) if needed)

Location: (Provide at least state and area initially) ____________________________________

Maximum number of people allowed to attend _____________________________________

Provisions for food, if applicable _________________________________________________

FOR OUR INTERNAL RECORDS, ("Contact" info for the site is what is given above)

FULL NAME ____________________________ PHONE ___________________

FULL ADDRESS __________________________________________________________

________________________________________________________________________

ORGANIZATION _____________________________________________________

EMAIL ______________________________ FAX ________________________________________