Oil and Gas Industry Responsibility Petition Endorsement Form
Date 
Organization or Individual 
Email Address: 
Phone Number 
Mailing Address: 

For Organizations:

Contact Person: 
Number of Members: 
Description of Organization: 
Endorsed by action of: 
on (date): 

I/we will support the Oil and Gas Industry Responsibility Petition by:

Asking the following organizations to  endorse the petition 
Asking the following elected officials to  endorse the petition 
Writing a letter to the editor in support of  the petition 
Writing a letter to Interior Secretary Dirk  Kempthorne in support of the petition 
Other