Sign-on Permission Form

Please add our name to those displayed at the Hague in support of this statement:


Organization name__________________________________________________________

Address_____________________________________________________________________________

City, State, Zip, Country______________________________________________________________

Phone___________________email___________________________________________________

Authorized by (Signature)_______________________________________________________________________

Print name & title________________________________________________________________


Please fax this completed form to: Sovereignty International (901) 986-2299 before October 31, 2000

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