Participation Card

Use this form to request information or publications from VI or to sign up for Verbree International mailing lists. All fields are optional but be sure to fill in your email address or mailing address as appropriate for your selections below.

Name
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Email

I would like to receive your FREE monthly newsletter ...

by mail by email

I would like to receive your FREE semiannual periodical, "Bridgin the Gap"...

by mail by email

Please send me by mail some additional Verbree International so I can help raise awareness among my friends and family or at my place of business, church or community organization.

Send me general brochure(s). Qty.:
Send me technical brochure(s). Qty.:
Send me info. about Burkina Faso. Qty.:
Send me donor packet(s). Qty.:
Send me project info. Qty.:

I would like to receive information on becoming a VI Board Member.

I would like to freely offer my skills and/or advice in the following ways:

If you have any questions, comments, suggestions, or feedback, please type them here.