Kansas TASK - Join TASK Form

Why join TASK? The answer is simple. You get to:

Meet other teens; make a difference in your community; be a positive role model; take a stand against the tobacco industry; learn how to talk to media; host events; have fun!!

For information regarding affiliating your group or organization with TASK, please contact 1.877.602.0368

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Send me a FREE TASK t-shirt:*	S M L XL 2XL
Your Name:*
Address:*
City:*
State: (KS only residents)	KS
Zip Code:*
Age (12-18 only):*
Phone with Area Code:*
E-mail:*
School:*
Year of Graduation:*
Why do you want to join TASK?
	To submit this form, please enter the characters you see in the image:

By submitting your contact information (name, address, e-mail address) you are stating that you want to join us in our stand against big tobacco and that you want to receive information about TASK activities.