To donate to the Committee to Elect Mary Shope by mail, print out this page, complete the information below and mail to:
State law requires us to collect the following information:
Name: _______________________________________________________
Address: _______________________ City: _______________ State: _____ Zip Code: ____________
Occupation: __________________________ Employer: ____________________________
Optional - Phone (___) ___- _____ Email: ________________________________________
If you would like to be a recognized supporter of Mary Shope and give us permission to use your name in advertisements or to be listed on this website please provide a signature with this form.
___________________________________
Your signature
Thank You for your support!
Contributions are not tax deductible. All contributions must be made from personal funds and may not be reimbursed or paid by others. Individual contributions are limited to $390. Contributions from corporations and foreign nationals who are not permanent residents in the