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)
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 ________________________________________