Contribute to the David LaGrand Campaign
BY CREDIT, DEBIT, OR EFT
Please contribute via PayPal®
BY MAIL
PLEASE PRINT THIS FORM AND MAIL TO
Committee to Elect David LaGrand
1167 Hall ST SE
Grand Rapids, MI 49507
$500 $250 $100
I would like to help David LaGrand
by contributing the following
The maximum donation allowed per person per election cycle is $500.
| State Law Requires the Following Information | ||
Name: |
||
Home Address: |
||
City: |
||
State: |
zip: | |
Occupation: |
||
Employer |
||
Business Address: |
||
City: |
||
State: |
zip: | |
| Please Complete this Optional Section | ||
Home Phone: |
||
Work Phone: |
||
Fax Number: |
||
E-mail address: |
||
Name of Spouse: |
Make checks payable to: The Committee to Elect David LaGrand
By law, corporate checks are not allowed and as such we can only accept Personal Checks. Please remember that contributions are not tax deductible as charitable contributions for Federal Income Tax purposes. For further information please contact Lance Penny, Campaign Manager at lance@davidlagrand.com
Paid for by the Committee to Elect David LaGrand, 1167 Hall ST SE, Grand Rapids, MI 49507