PRINT this form, fill in the requested information and MAIL it with your enclosed CHECK or MONEY ORDER to:

Citizens for Sherman Parker

P.O. Box 655

St. Peters, MO 63376

 

Donation Amount (Circle one)

$1000           $250

$100             $50

$25                   

Other Amount Please specify ___________________

 

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.

 

 
 
   
   
 
 
 
 

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Sherman with Maryland Lt. Governor Michael Steele

 

Sherman with Christine Todd Whitman Former EPA Administrator and Former New Jersey Governor

Sherman with Hall of Famer and Pennsylvania Gubernatorial Candidate, Lynn Swann

  

Sherman Parker

 

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Paid for by Citizens for Sherman Parker
Josh Campbell, Treasurer