OCTOBER 2nd: ADHESION COUPON FOR THE FASTING DIALOGUE

(X) I adhere to the fasting dialogue for the liberation of Gedhun Choekyi Nyima, XIth Panchen Lama, and of the Chinese dissident Wei Jingsheng.

* I have the intention to fast during

(X) 3 Days

* We would like to know the dates of your fasting:

(X) September 30th

(X) October 1st

(X) October 2nd

Name: Mr. Daniel Hodel

Complete address:

4649 Sunnyside Avenue N., #323

Seattle, WA 98103

Country: United States of America

Telephone: (206) 547-1015

Fax: (206) 547-3758

E-mail

Profession/function: President, Board of Directors

Organization: Tibetan Rights Campaign