Wednesday, April 15, 2009

Donations

The quickest way to donate to Andrea's campaign is by using our secure credit card donation system.  Click here to donate via credit card.

If you would like to donate by check, please fill out the form below and print it.  After submitting the form on the website, include your printed form with your check.

Thank you for supporting Andrea's campaign.


SunLogoLarge02 40 percent

Mail-in Donation Form for Andrea Dalessandro
Thank you for your donation. Please include all the required fields below. Please note, your donation is a political contribution under federal law and will be used for an Arizona election campaign. Your donation is not deductible for US federal income tax purposes. Additionally, the individual contribution limit is $410 per individual.

After filling out the form, select "PRINT" from your browser BEFORE selecting "SUBMIT". Once you submit the form, it will go into our database so we know to expect the check, however, you will be unable to print the form with your information. Again, please print before submitting.

Make checks payable to: "Andrea for AZ"

Please mail this form along with your donation to:

Andrea for AZ
PO BOX 945
Green Valley, AZ 85622-0945
1.By checking the boxes below, you affirm that all of these statements are true and correct. *
  • This contribution is made from my own funds, and not from those of another.
  • This contribution is not made from the general treasury funds of a corporation, labor organization or national bank.
  • This contribution is made on a personal credit card for which I have the legal obligation to pay, and is not made either on a corporate or business entity card or on the card of another person.
  • I have not donated in excess of $5,850 to candidates and campaign committees who give to candidates in Arizona this calendar year.
  • I affirm that all of the above statements are true and correct.
2.Donation Amount: *
3.'Other' Amount Donation:
4.First Name: *
5.Last Name: *
6.Address: *
7.City: *
8.State:
9.Zipcode: *
10.Email: *
11.Phone # With Area Code: *
12.Employer: *
13.Occupation: *
 


CLICK HERE TO PRINT

.

Paid for by Andrea for AZ © 2009

.

Andrea AZ © Template Nice Blue. Modified by Indian Monsters. Original: Our Blog Templates, Blogger Styles. Latest Design: Athena's Alchemy