U2K Endorsement Form  - print from browser - write on line above description.

U2K Campaign Pledge 

	 We believe that:
	- everybody needs access to quality comprehensive health care.
	- health care is a basic human need and a basic human right.
	- the 1990s market-based solution to America's health care problems is
	failing and the crisis is getting worse.
	- it is a moral outrage and a national disgrace for the United States 
	to be the only longstanding democracy to enter the 21st Century 
	without a national guarantee of health care for all its people.

	We commit our organizations to:
	- use the 2000 elections as the beginning of a sustained effort to 
	ensure comprehensive, quality, affordable health care for all.
	- work with other groups and associations toward this end.

	We call on all candidates running for office in 2000 to commit 
	themselves to making universal health care a top priority in the 
	next legislative session.

______________________________  ___________      Local - Regional - State - National
Organization Name             Cong. District        (Circle type of organization)          

Initial level of endorsement:  ENDORSER - EDUCATOR - NETWORKER - COORDINATOR
                                        (Please circle one.)

Authorized by: ___________________________   _______________________________
                         Printed name                    Signature

____________________________________  ______________________________________
        Organizational title              contact person (if different)

or Individual Participant __________________________________________________

_______________________  _______________________  ___________________________
Street Address                  City                State & zip code

_______________________  ______________________   ___________________________
    Telephone No.               Fax. No.                    E-mail

As a grassroots campaign, the U2K Campaign relies heavily on the voluntary
contributions of its supporters.  Because the U2K Campaign is an educational 
campaign and does not endorse candidates or legislation, contributions are 
tax-deductible.

Make checks payable to "U2K Campaign."  $_________________   $___________________
                                        (enclosed)              (pledged)
Or charge to _____MasterCard  _____Visa  ______AMEX

______-______-______-______     ___________________________    ____/____/____
        Account #                         Signature             Exp. date

For information, U2K Campaign:  Tel. (216) 902-5577  Fax (216) 241-8423
E-mail:  info@u2kcampaign.org    Website:  http://www.u2kcampaign.org
Mail to:  U2K Campaign, 2800 Euclid Ave., #520, Cleveland, OH  44115-2481

Form designed and distributed by MichUHCAN, 8846 Robindale, Detroit, MI  48239
Form available on the World Wide Web at http://michuhcan.tripod.com
May be reproduced and used for free by anybody at any time.