I, the undersigning ................................... ...................................

(Christian name) (Surname)

Mayor/Provost of ....................................................................

Council .............................................

..............................

(Country)

hereby express my support for the international campaign

"Freedom for Tibet".

I also engage to hoist the Tibetian flag on the townhall on

March 10th 1996,

the anniversary of the 1959 uprising in Lhasa.

I would like to donate .................... towards the campaign

which I am going to send to the account No. 310-1075385-32

(Bank)

of the Radical Party, transnational and transparty.

........................................

(Signature)

Please send the Tibetian Flag to me

at the following address: ......................................................................................................................................

......................................................................................................................................

Radicale Party, transnational and transparty

___________________________________________________________

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