Petition for a National Referendum on Whether United States Troops Should be Pulled out of Iraq

Coalition for National Referendum

Petition for a National Referendum on Whether United States Troops Should be Pulled out of Iraq on the Condition That the United Nations Provides a Peace Keeping Force in Iraq

Please fill out all fields. You may 'Print' this form if you would rather mail the vote. Otherwise, click on 'Submit' when finished. Thanks!

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Title:

First Name: *

Middle Initial:

Last Name: *

Address: *

City: *

State: *

Zip Code: *

Email: *

By submitting this form, I am signing a petition requesting that Congress pass Legislation to place on the Ballot a National Referendum Question which would state: Should American troops be pulled out of Iraq on the condition that the United Nations, on a temporary basis, provide a Peace Keeping force for the security and assistance of the Iraqi people?

If you wish to mail this petition, mail to:
Coalition for National Referendum
99 Clinton Street Suite 111
Concord, NH 03301

Please feel free to copy and print this petition and distribute to others so that they may sign. You can also send more than one person's signed petition in the same envelope. It is not necessary to have an email address for those petitions submitted through the regular postal mail system. Thank you!

Title:
First Name:	*
Middle Initial:
Last Name:	*
Address:	*
City:	*
State:	*
Zip Code:	*
Email:	*