Mississippi Parents for Vaccine Rights Membership Form

Mississippi Parents for Vaccine Rights (MPVR) champions state and federal laws that advocate the basic human right of parents to be the final authority in their children's healthcare, particularly vaccinations. In a climate of increasing government control over healthcare, we are focused on defending the freedom of informed voluntary consent for all.

*NOTE: Healthcare and related professions: Due to increasing demand, MPVR has formed Healthcare Professionals for Informed Consent. We hope you will join us in working to correct laws and policies that adversely affect employment based on vaccine status, in addition to promoting informed consent in childhood vaccinations.

By completing our membership form, you are expressing interest in supporting MPVR's goals. Please be assured that your personal information will be kept confidential, and is essential for organizational purposes. Your contact data will be used only by our leadership for limited alerts and calls to action.

Thank you for getting involved,

MaryJo Perry
MPVR CoDirector
601.540.1665

Lindey Magee
MPVR CoDirector
601.341.4359

Name *

First Name Last Name

Facebook Name (If applicable)

E-mail *

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Cell Phone Number *

- Area Code Phone Number

County *

The following two fields are asking for your state lawmakers, not U.S. Please go to www.openstates.org and enter your address to find out who your State Representative and State Senator are.

Knowing who your state lawmakers are and developing a working relationship with them is vital to the success of our efforts. Please take a minute to put their contact information in your phone for future reference.

State Representative

First Name Last Name

State Senator

First Name Last Name

Please refer to the map below to determine which MPVR Regional Chapter you fall under.

Central Mississippi Chapter Delta Chapter Golden Triangle Chapter Greater Hattiesburg Chapter Gulf Coast Chapter North Mississippi Chapter Northeast Mississippi Chapter Southwest Mississippi Chapter

If you have experience working in a healthcare or related field, please specify:

If you have experience working in an education or related field, please specify:

Please briefly describe any skill, work experience or insight you have that might benefit MPVR:

0/150

I have a vaccine injury/death story I am willing to share I have been terminated by a pediatric clinic because of vaccine non-compliance My vaccine status has adversely affected my ability to obtain or maintain employment in a healthcare or related field.

MPVR is largely a grassroots volunteer effort. The pharmaceutical industry, with cooperation from medical trade organizations and agenda-driven bureaucracies, constitutes the most powerful and wealthiest lobby in history.

Your donations will help us promote our organization and expand our membership through advertising and print material, as well as offset lobbying and organizational expenses. We are grateful for any amount you are able to give and are committed to use our resources judiciously.

Donate to MPVR

USD via PayPal

Thank you for joining! Please take a moment to bookmark and visit
www.MPVR.org
If you will scroll to the bottom of our site you will see our Activist Links with information to download and print, as well as past posts. Please review our Guidelines, sign our petition, and access the valuable resources we have put together for you. We want to help our members be prepared to share our mission with others and begin communicating with your legislators. With every one of us working closely with our own lawmakers, we can change our laws.

Name

First Name Last Name