Demand the Change for Children List Question Title * 1. First Name Question Title * 2. Last Name: Question Title * 3. Mailing Address: Question Title * 4. City Question Title * 5. State: Question Title * 6. Zip: Question Title * 7. E-mail Address: Question Title * 8. Why do you care about preventing child sexual abuse? (Please check all that apply.) I am a parent of a child(ren) under age 18. I am a responsible adult, concerned about the safety of all children. I have friends and/or family who were sexually abused as children. I have friends and/or family with sexual behavior problems. I was sexually abused in childhood. I work with children and/or families. I want to take action to prevent child sexual abuse. I prefer not to answer. Other (please specify) Question Title * 9. I permit Demand the Change for Children/Minnesota Coalition Against Sexual Assault to list me as supporting child sexual abuse prevention. Yes No Question Title * 10. I want to be kept informed via periodic e-mail updates about efforts to Demand the Change for Children. Yes No Question Title * 11. I want to get involved in making my community safer for all children. Please let me know how I can help. Yes No Done