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Thanks for your interest in becoming vegan! As a vegan, you'll live a life of both principle and pleasure, and your vegan mentor will help you along the way.

Please fill out this form, the answers to which will be used to conduct a suitable match-up with your mentor; starred fields are required--all information will be kept private and will only be used internally to match you up with a mentor. Thanks!

Name *

First

Last
Email *
Mailing Address (for us to provide you with a vegan starter pack) *

Street Address

Address Line 2

City

State / Province / Region

Zip Code

Country
Phone Number *

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Age *
Gender *
 Male 
 Female 
 Transgender/Other 
Hobbies (list top 5) *
Which pledge works for you? *
 I would like to try out being vegan. I pledge to be fully vegan for one full month from my start date. During that time I pledge not to consume any meat, dairy, or other products from animals or purchase any new clothes made from animals. 
 I would like to try out being vegan but I would like to make a transistion first; I pledge to phase out all animal products and then be fully vegan for one full month of doing so. 
 I want to be vegan for life. And I can begin right from my start date. I pledge not to consume any meat, dairy, or other products from animals or purchase any new clothes made from animals. 
 I want to be vegan for life, but I would like to make a transisition first. I pledge to phase out all animal products with the pledge of being fully vegan. 
Date in which you would like to start your pledge and mentorship *

MM
/
DD
/
YYYY
Have you ever tried being vegan before? *
 Yes 
 No 

How often do you eat the following?

Red Meat *
 Most meals 
 Once daily 
 Up to 3/wk 
 Up to 3/mo 
 Never 
Poultry *
 Most meals 
 Once daily 
 Up to 3/wk 
 Up to 3/mo 
 Never 
Fish/Seafood *
 Most meals 
 Once daily 
 Up to 3/wk 
 Up to 3/mo 
 Never 
Other Meat *
 Most meals 
 Once daily 
 Up to 3/wk 
 Up to 3/mo 
 Never 
Eggs *
 Most meals 
 Once daily 
 Up to 3/wk 
 Up to 3/mo 
 Never 
Dairy *
 Most meals 
 Once daily 
 Up to 3/wk 
 Up to 3/mo 
 Never 
Are there any special needs we should be aware of?
For instance, if you are pregnant or breastfeeding, an athlete, have any food allergies, we can try and find a mentor who best suits your needs.
Why have you decided to go vegan?
Do you anticipate any problems in becoming or being vegan?
Is there anything you think you will miss most of all?
Do you think you will have the support of family and friends? Are any of them already vegan?
Any additional comments?
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Northwest Animal Rights Network (NARN)
1037 NE 65th ST #174
Seattle, WA 98115
206-250-7301