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Privacy Policy and Authorization Verification

By submitting the requested information, you acknowledge:

1. That you are an American citizen born in Jerusalem who wishes to have “Israel” listed as the place of birth on your U.S. Passport; and
2. That you wish to be considered a member of the ad-hoc Association of Proud American Citizens Born in Jerusalem, Israel.
3. You further authorize the Anti-Defamation League and Mintz Levin to file an amicus brief on your behalf (as a member of the ad-hoc Association of Proud Americans Born in Jerusalem, Israel) in the U.S. Supreme Court in the case of Zivotofsky v. Clinton.

The information that you provide when you sign up on this website – including your name and contact information – will remain confidential and will not be published.  The names of the individual members of the Association will NOT be included in the amicus brief.  The names will only be provided to the Court if requested by the Court.  The information you provide will be retained by the Association and will not be made public.

I have read the Privacy Policy, Verification and Authorization.  I verify that I am an American citizen and the information I have provided above is true and accurate. I wish to have my voice heard as a member of the ad-hoc Association of Proud Americans born in Jerusalem, Israel and I authorize the Association, the ADL and Mintz Levin to proceed.