Coalition Member Application

Thank you for your interest in joining the Coalition for Informed Consent (CIC). The purpose of the coalition is to unite, empower, and activate organizations, businesses, communities, and bloggers who support:

1) Safeguarding informed consent in vaccination.
2) The repeal of mandatory vaccination laws.

Please sign up below and you will be contacted once your application has been processed.

Thanks again for your support!

Greg Glaser, JD
National CIC Director

Become a Coalition for Informed Consent Member today!

Coalition Profile
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Coalition Contact Profile
Yes, I have authority on behalf of my organization/group to join the coalition with PIC.
 
Yes, I agree for my organization to be listed (including our logo) as a member of this coalition for purposes of PIC media and outreach.
 
Coalition membership does not create a partnership or joint venture. Each coalition member remains independent. Coalition membership may be terminated at anytime in writing by either party. Acceptance and approval of membership applications for the Coalition for Informed Consent is within PIC's full discretion.
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