Your Name:

Sex:
Male
Female

Birth date:

Street Address 1:

City: State/Province: -- AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY -- GU PR VI -- AB BC MB NB NF NS NT ON PE PQ SK YT Zip Code/Postal Code:

Phone: --

Do you have access to E-mail or fax? If so, please print e-mail address and/or fax number?

Your occupation (If a student, where and what year?

Applicants Signature       Signature of Legal Guardian if under 18       Date

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Please answer the following questions on a separate sheet of paper and return with the application.

• Why would you like to be a Core Marcher on the Global March Against Child Labor?

• What involvement have you had with the issue of child labor?

• What special abilities or qualities do you feel you would bring to the Global March?

• Do you have any disabilities, special dietary needs, religious requirements, health conditions or other circumstances that could affect your participation in the March?

• How long will you be able to participate as a Core Marcher?

• At which location would you like to begin your participation? At which location would you like to end your participation?

• Would you like to apply to be one of the Marchers who will travel to Geneva, Switzerland? If so, do you have a valid passport?

• If you are between the ages of 13 - 16, can you identify a chaperone who would be able to accompany you on the March?

Leah Nayman
Global March Against Child Labor
733 15th Street, NW, Suite 920
Washington, DC 20005
TEL: (202) 347-3817
FAX: (202) 347-4885

For more information on the march, click here.