MAILING IN YOUR DONATION?
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You can make a contribution online. To contribute online, please click the donate button below: If you would like to make a donation by check, please mail the following completed form with your check to: Alan Fine for U.S. Representative Please make check payable to: Fine for Congress. The maximum amount an individual can contribute to a Congressional race is $2100 for the Primary and $2100 for the General. Every amount is appreciated! |
First Name ___________________________________ Middle Initial _____ Last Name ____________________________________ Suffix ________ Spouse's Name ________________________________ Middle Initial _____ Last Name ____________________________________ Suffix ________ Your Mailing Address____________________________________________ City_______________________ State________ Zip Code___________ Home OR Work Phone required: Home Phone _________________________ Work Phone _____________________ Fax _______________________ E-mail ________________________________ Your Employer _____________________ Your Occupation _____________________ Amount of Donation $_________________________________________ |