!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> Sign up to show your organization's support for Federal Legislation

Sign up to show your organizations support for Federal Legislation:

All Lyme groups, or Non-Lyme groups, or Corporations who are in favor of S 1708 / HR 741, The Lyme and Tick-Borne Disease Prevention, Education & Research Act of 2007, please complete the following form so that we can add you to the list of groups in support of the bill. By filling out this form, you agree that you have the legal authority to sign on behalf of the organization you list.

THIS FORM IS NOT FOR INDIVIDUAL SUPPORTERS OF THE BILL; ONLY GROUPS IN SUPPORT OF THE BILL.


Organization Name
Type Of Organization
Website
Email
Title
First
Last
Phone () - Clear
Fax () - Clear
Street Address
Unit/Suite/Apt.
City
State
Zip Clear
County
Country
Geographic Area Served OR Other

Please contact Lia McCabe at: lmmccabe@hvc.rr.com if you have any questions.

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