Join the Basel Action Network!
Please print and fill out this form, then fax it to 1-206-652-5750 or mail it to:
The Basel Action Network
122 S. Jackson Street, Suite 320
Seattle, WA 98104
USA
|
Organization Name: |
___________________________________________________ |
|
Contact Person: |
___________________________________________________ |
|
Position: |
___________________________________________________ |
|
Mailing Address: |
___________________________________________________ |
|
E-mail: |
___________________________________________________ |
|
Website: |
___________________________________________________ |
|
Phone: |
_______-________-___________________________ |
|
Fax: |
_______-________-___________________________ |
Please note, this form is NOT for those who are interested specifically in our e-waste program, the e-Stewards Initiative. If you are a company seeking to become a part of the e-Stewards Initiative, please visit www.e-Stewards.org for instruction.