Only sections with * are required.

LET'S BUILD THE PEOPLES' SENATE

Read Peoples' Senate At-A-Glance

TODAY'S DATE * +

NAME *

EMAIL *

PHONE *

CITY/STATE/REGION *

How did you hear about the Peoples' Senate?

Social Media

Paper/Mailing

Word of mouth (Who?) Word of mouth (Who?)

The following questions will assist the Peoples' Senate Organizing Committee in identifying and connecting the various perspectives in this mass organizing initiative.

JOB/OCCUPATION

Are You Representing an Organization? Do you work with an Organization? If so, what Organization?

Did you attend the Spirit of Mandela 2021 International Tribunal? *

YES

No, but I am otherwise involved and aware of the SoM Tribunal Outcomes/Committees.

Did you attend the Feb 18, 2023 Peoples’ Senate Intro Webinar? *

YES

If you're with an Organization, please describe your Organizational Mission/Goals (1 or 2 sentences)

DO YOU OR YOUR ORGANIZATION currently organize around any of these

issues of Genocide?

Racist police killings of Black, Brown, and Indigenous people

Hyper incarceration of Black, Brown, and Indigenous people

Political incarceration of Civil Rights/National Liberation era revolutionaries & activists, and present day activists

Environmental racism and its impact on Black, Brown, and Indigenous people

Public health racism and disparities and its impact on Black, Brown, and Indigenous people

OTHER issues related to genocide against Black, Brown, and Indigenous people? OTHER issues related to genocide against Black, Brown, and Indigenous people?

Please provide your Personal and Organizational Social Media (Facebook, Instagram, Twitter, TikTok, YouTube, etc) *

We hope you will follow Spirit of Mandela Social Media accounts!

Twitter: @inthespiritt

Facebook: SpiritOfMandela

Instagram: @spiritofmandela

YouTube: @spiritofmandela9139

Website: spiritofmandela.org

Groups / Organizations you formerly or currently affiliate with: *

Please check all that apply.

I want to stay in touch with Peoples’ Senate organizing & continue to receive information.

I can volunteer to become an Active Organizer for the Peoples' Senate.

I'd like to help organize a regional conference or local initiative to help build the Peoples’ Senate.

I can commit the organization I am part of to engage with the Peoples’ Senate.

Other Other

ANYTHING ELSE?

Thank You!