Survey / Petition / Poll Form Page  1 of _____   Date: ___/___/____
Subject: National Council's Bible Curriculum in Public School , Volunteer Name(s):______________
School District: _______________________
School Board Ph.# _____ -_____ -__


MAIL for receipt on/before: ______________  for the ____________ Sch Bd Meeting.
MAIL to Organizer: ____________________ 
Org. Email: ______@____________
Org. Address:  _________________________
Org. Ph #    _____ -_____ -________
Org. ST/Zip:    _________________________
Org. Fax #   _____ -_____ -________
Statement of Objectives For This Survey / Petition / Poll.
    WE, THE UNDERSIGNED, RECOGNIZING THE U.S. CONSTITUTIONAL RIGHT TO HAVE A STATE APPROVED BIBLE COURSE CURRICULUM, ENCOURAGE THAT SUCH AN ELECTIVE COURSE CURRICULUM BE OFFERED IN THE PUBLIC SCHOOL SYSTEM OF THIS STATE.
    AS CONCERNED CITIZENS, WE DESIRE THAT THIS CURRICULUM [NATIONAL COUNCIL'S BIBLE CURRICULUM, UNCHANGED AND IN IT'S ENTIRETY, (as in 29 other states)] BE IMPLEMENTED IN THE PUBLIC SCHOOL SYSTEM, AND WILL VOTE FOR IT ACCORDINGLY.
              _COMPLETE  INFORMATION  WILL  MAXIMIZE  YOUR  EFFORT  &  ENCOURAGE  OUR  VOLUNTEERS.    ___    _
| Name (Signature)+ print last
| Street Address
 |  City / ST / Zip
|   Ph # / Email:
Student (S), Parent (P), |
Citizen (C) / I  will help (H). |
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