EMERGENCY GUN RIGHTS SURVEY

A project of Citizens Committee for the Right to Keep and Bear Arms

 

1. Do you think that the so-called "Assault Weapons Ban" that expired in September of 2004 should be reauthorized?

YES NO

2. Do you support Obama's attempts to possibly repeal the Second Amendment by stuffing the Supreme Court full of raving radicals?

YES NO

3. Do believe that allowing law-abiding citizens to carry concealed firearms, if they chose to, helps reduce crime and could potentially help stop terrorists from acting within our borders?

YES NO

4. Do you support the UN gun treaty and their push to internationally regulate firearms?

YES NO

5. Do you believe it is important for law-abiding gun owners and freedom loving Americans to unite and actively work to protect their gun rights?

YES NO

Receive Two
"Keep the Change"
Stickers With
Every Donation!
Yes, I want to support the CCRKBA with a much-needed contribution of:
$10 $20 $40 $80
$100 Your most generous gift: $ . *
Please enter numbers only, no decimal points or commas.
I do not wish to donate at this time.
 
Your Full Name:
(as it appears on your credit card)
*
E-Mail Address: *
 

Billing Address:

Street Address: *
City: *
State: *
Zipcode: *
Phone Number:
Fax Number:

Required fields are marked with an asterisk (*)


 
I want to donate the above amount:
One-Time
Weekly (every 7 days)
Bi-Weekly (every 14 days)
Monthly (every 30 days)
Bi-Monthly (every 60 days)
Quarterly (every 90 days)
 

Credit Card Number:
(Please enter numbers only,
no dashes or other punctuation)
*
Credit Card Expiration Date: Month * Year *
Credit Card CVV Security Code:
(What's this?)
*

I have read and agree to the policies below.

You will have the opportunity to review your donation details on
the next page before your credit card is charged.


Security, Privacy, Refund & Recurring Donation Policies

VISA MC AMEX DISC

To send a check, please complete and print this form,
and mail it with your donation to this address:

Citizens Committee for the Right
to Keep and Bear Arms (CCRKBA)

Liberty Park
12500 N.E. Tenth Place
Bellevue, WA 98005

Please make checks payable to CCRKBA.

CCRKBA is a 501(c)4 non-profit organization.
Contributions to CCRKBA are not tax deductible for federal income tax purposes.