Campus Outreach Interest Form

Thank you for your interest in the Campus Outreach Team! If you would like more information regarding any aspect of the Tour, please fill out the form below and we will contact you:

Name

First Name

Last Name

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email Address

Date of Birth

YYYY

High School or College

Location of High School or College

If you are a member of a pro-life group in your area please complete the following

Name of group

City

State

Your level of involvement

The High School or College campus you would like the Survivors Campus Outreach team to visit.

Survivors

Survivors is a Christian, pro-life activism organization dedicated to educating and activating high school and college age individuals.

If you were born after 1972, we challenge you to consider yourself a Survivor of the Abortion Holocaust. 1/3 of your generation has been killed by abortion in America!

The Survivors are taking an active stand on behalf of those who have already been lost, and for those who are scheduled to die through abortion. We are empowered by the truth, enabled by extensive training, and unafraid of condemning the death of innocents.

Campus Outreach - Interest Form

Campus Outreach Interest Form

Survivors