Membership Form

Individual Member

Sign me up as an individual member of Coalition for Responsible Sex Ed-MN.

Agency Partner

Our agency supports Coalition for Responsible Sex Ed-MN and agrees to sign on AND be listed as a coalition member.

Our agency supports the coalition, but CANNOT be listed as a coalition participant. Please keep us informed of Coalition for Responsible Sex Ed activities.

Primary Contact

*The fields with an asterisk are required.

First Name:*
Last Name:*
Job Title:
Agency:
Mailing Address:*
Note: In order to match you with the correct legislative district, we need your full home address, if it's different from the address you listed above. We will not contact you at your home address, unless we have difficulty reaching you at your mailing address.
Home Address:*
City:*
State:
Zip:*
Phone:*
Fax:
Email:*
    

If this form does not work for you, please email moappp@moappp.org with the above information and the subject "Add to SEFL".

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Contact Us

For more information about the Coalition and how you can participate please contact us at 651-644-1447 x12 or lorie@moappp.org.