Hoosiers Concerned About Gun Violence 1201 N. Central Avenue Indianapolis, IN 46202 ********************************* Name____________________________ Address__________________________ City__________________Zip________ Phone__________________ Email____________________________ Annual Membership fee: _______Adult ($25) _______Student ($5) _______Church/Organization ($100) Check below if you are interested in: ___Receiving email updates/newsletters ___Contacting your legislator ___Volunteering