Donation Info
$25 $50 $100 $250 $500 $1,000 $2,500 Other:

Card Number: Card Type:
EXP Date: CVV:

Contributor Info
First Name: Last Name:
Street Address: Suite Number:
City: State: Zip Code:
Phone: Email:

Employment Info
Occupation: Company:
Michigan election law> requires candidate committees to report the mailing address, occupation and name of employer for each individual whose contribution aggregate in excess of $100 in an election cycle. Please report the required information.
$3,400/person is the maximum contribution allowable by" state law. (No corporate checks please.) Michigan election law requires candidate committees to report the mailing address, occupation and name of employer for each individual whose contributions aggregate in excess of $100 in an election cycle. Please report the required information.