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* 1. Are you an AXA client?

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* 2. Knowing that AXA invests in Israeli banks that directly finance and maintain Israel's illegal settlements, would you change your insurance company?

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* 3. Are you an AXA shareholder?

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* 4. Knowing that AXA invests in Israeli banks that directly finance and maintain Israel's illegal settlements, would you use your power as a shareholder to pressure AXA to divest from Palestinian human rights violations?

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* 5. Please fill in your name

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* 6. Please fill in your e-mail address

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