Coalition for National Referendum

Petition for Referendums in Cities Throughout the United States on Whether the United States Should Go to War With 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!

Fields with * are required.

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


By submitting this form, I am signing a petition requesting that my City place on the Ballot a Referendum Question on Whether the United States Should Go to War With Iraq.

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!