ELEVENTH ANNUAL 40-HOUR FAST America's Broken Promise March 15-17, 2006 Yes, I will fast at some time between 8 p.m. on Wednesday, March 15 and noon on Friday, March 17, 2006. Please provide the following information [* = required field] Name* Street City State Zip Phone, day Phone, evening E-mail* I would like to set up a FAST event in my community. Please call me, so that my event can be listed along with other statewide events. Please let me know about FAST events in my region. Please send 10 brochures (5 in English and 5 in Spanish) that I can post and distribute in my community. Please contact me about other ways I can help. NOTE: Donations to help spread word about the Fast are welcome. Please print this form and mail it with your check or call us at 518/ 213-6000 ext. 6294 to donate by credit card. THANK YOU! NYS Labor-Religion Coalition 800 Troy Schenectady Road Latham, NY 12110-2455