Please fill out this form and check below the ways in which your organization would like to participate.

Organization Name
   Mailing Address    Phone
                        City State  Zip
President/Director
                       Phone   E-mail
 Project Contact Person
Phone Cell Phone
FAX        E-mail 

Please contact us about speaking to our membership about this issue and project.

  Please provide us with information we can distribute to our membership and others in our community.

  Please provide us with information we can put in our newsletter or on our website.

  Please contact us about participating in Press Conferences related to this project.

  We may have members who would be willing to discuss their concerns about this new law and its impacts with the media and who are willing to be interviewed for newspaper articles.

Please contact us regarding other organizations or individuals we think FCAN Foundation should contact in our area about this project.

  Please contact us about other ideas we have about this project.

Enter additional comments or suggestions in the space provided below:

Submitted by:    Title: 

Date: 

Thank you for participating in this important community education project!

For more information please contact: Florida Consumer Action Network Foundation, (813) 877-6712   www.fcan.org                   

Florida Consumer Action Network Foundation is a statewide 501c(3) non-profit citizen organization with 40,000 members. FCAN Foundation sponsors research and public education on matters affecting the quality of life of the residents of Florida.  Issue areas include environmental protection, utility cost and regulation, insurance reform, health care, and similar issues.


Copyright © 2004.  Florida Consumer Action Network Foundation. All rights reserved.
Revised: November 26, 2007 .