PARSOL Sustaining Member Form Join the PARSOL Sustaining Donor Program Use this form and check the recurring contribution monthly option to donate and become a member of the PARSOL Coffee Club! The idea is that for the price of a cup of coffee ($5) or more you can make a difference in funding PARSOL's mandate of fighting unfair and unjust registries and related sex offense policies. Please be sure to check "I want to contribute this amount every month" below. Contribution Amount $ 5.00 $ 10.00 $ 25.00 $ 30.00 $ 40.00 $ 50.00 $ 75.00 $ 100.00 Other Amount Other Amount $ Total Amount I want to contribute this amount every month year The Pennsylvania Association for Rational Sexual Offense Laws (PARSOL) is a nonprofit organization working toward a fair and just Pennsylvania for all. PARSOL promotes legislation that seeks to increase prevention of sexual abuse and protect the civil rights and effective rehabilitation of those who have offended. We are pleased to know that there are people like you who share the same ideals as us and want to make a difference in the Commonwealth. Please complete this form in its entirely. Thank you! A Pennsylvania Safe and Just for All Member Form Email * First Name * Last Name * Suffix Jr. Sr. II III IV V VI VII Esq. Street Address (Primary) City (Primary) Please type in the first few letters of your state to find it in the list. State (Primary) - select State/Province - Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Postal Code (Primary) Phone * Are you 18 or older? * Yes No Relation to this issue * Academic Researcher Concerned Citizen Family Member Friend Government Person who is Incarcerated Legal Professional Mental Health Professional Other/No Response Person Forced to Register (or Similar) Reentry Professional Sexual Abuse Survivor Choose any that apply Supervision Status * I am not under supervision I am under supervision of county probation or parole I am under supervision of PA State probation or parole I am under supervision of Federal probation or parole I am a person who is incarcerated. By submitting my information to PARSOL, I agree that I have read, understand, and pledge my support to the mission of PARSOL and that I will not use information obtained through PARSOL to threaten, intimidate, or harass any individual, organization, or entity associated with PARSOL. I agree to the PARSOL's data privacy terms. * Yes No Contribute