Coalition Member Application

Thank you for your interest in joining the Coalition for Informed Consent (CIC). The purpose of the CIC 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.

To join the CIC, please complete the form below.

Sincerely,

Greg Glaser, JD
National CIC Director

Coalition Profile

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Nonprofit and international organizations only.

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Coalition Contact Profile

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By selecting Yes I confirm I have authority on behalf of my organization/group to join the coalition with PIC.

Acceptance of Agreement *

Yes

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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