Donor Information:

Name _________________________________________________________

Street Address __________________________________________________

______________________________________________________________

City ___________________________________________________________

State ______________________________ ZIP ________________________

Home Phone ____________________________________________________

E-mail _________________________________________________________

Occupation* _____________________________________________________

Employer* ______________________________________________________

*Federal Law requires political committees to use their best efforts to collect and report the name, mailing address, occupation and name of employer for each individual whose contributions exceed $200 in a calendar year. Contributions from the following individuals and entities are prohibited: corporations, labor organizations, national banks, government contractors, foreign nationals, or people under 18 years of age. Contributions to  Citizens for Sherman Parker are not tax deductible.