To remove by disarmament all the threats of mass destruction and to create peace founded on cooperation, justice and the preservation of the earth,
I, the undersigned citizen of the world, of....................... nationality, DECLARE THAT:
[_] I refuse to live under the constant threat of nuclear, biological or chemical weapons of mass destruction, and I demand that all nuclear States eliminate all their nuclear arsenals;
[_] I consider that the money, intelligence and energy available should instead be invested in the peaceful resolution of disputes between people and States, in disarmament, education, the solving of human, health and social problems, the prevention of food and ecological catastrophes, the struggle against poverty, and in the sustainable, sure and just use of the planet’s resources ;
[_] I endorse therefore and wish to sign:
The World Appeal to Set the Planet Free from All Weapons of Mass Destruction; The Call for a referendum in France for nuclear, biological and chemical disarmament in an integral, universal and controlled manner ; The Petition for the total banning of all radioactive weapons
[_] I join ACDN [_] I rejoin ACDN
and attach a cheque for
[_] 15 € or 18$
[_] 10 € or 12$ (low incomes)
[_] 25 € or 30$(for a couple)
[_] I subscribe to « Assez des haines ! » and attach a cheque for 15 € / 18 US $ to: ACDN
[_] I contribute a gift of ..........................€uros or of....................US $ (cheques to: ACDN)
I wish to
[_] disseminate Appeals, petitions and bulletins from ACDN
[_] receive documentation to make representations to the following elected representatives or municipalities:
[_] contact the following associations or personalities:
[_] support the international campaign of the « Mayors for Peace » and the "Abolition NOW!" campaign
[_] request my Mayor, City Council or Region Council to support this campaign
[_] create a local ACDN group
[_] seek gifts or subsidies from:
[_] other propositions :
[_] I would like to receive information about the 2d Rally for International Disarmament (RID-NBC, Saintes, 6-8 May, 2006)
[_] I intend to be present
[_]Mrs [_] Mr [_]Ms. SURNAME : ........................................
First name : .........................
Address:
Phone:
FAX:
E-mail:
Profession:
Important office held (if any):
Place.....................................................,
Date....................... Signature :
Please send to: ACDN, 31 Rue du Cormier
17100 - Saintes
FRANCE
Fax: (++) 33 5 46 74 08 60