PERSONAL DETAILS

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      PERSONAL DETAILS

      First name:

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      Characters left: 120

      ORGANIZATION DETAILS

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      Full name of the organization:

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        PERSONAL DETAILS

        First name:

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        Characters left: 120

        ADDITIONAL INFORMATION

        Official name of your parliament:

        Expected end of current term (year):

        Your political party:

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        May we share a statement from you on this initiative (optional):

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        Yes, please keep me posted and add my email to the campaign mailing list

        Yes, as a current member of parliament I endorse the campaign and I agree that my name may be listed as a supporter. I give consent to the collection and use of the data entered above in accordance with the campaign's privacy policy

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