I,________________________________________, as a representative of
                        (please print your name)

affirm that this group, ______________________________________________,
                                                             (name of your organization or group)

has endorsed the Ten Affirmations for Gay, Lesbian, Bisexual, and Transgendered (GLBT) Spirituality. A majority of the members of this organization/group or a majority of the designated leadership body of this organization/group have voted to endorse these affirmations. You have our permission to publish and/or announce this endorsement to promote recognition of and response to the spiritual needs of gay, lesbian, bisexual, and transgendered persons.

________________________________________    _____________
Signature                                                                                        Date

If you would be willing to attend a press conference please provide your contact information below:

Phone number:________________________
Email address:_______________________________________

Please complete the form and forward to:

Janet Edwards
1117 S. Negley Ave.
Pittsburgh, PA 15217