YES! I want to support the Davidson County Democratic Party as it works for economic opportunity, quality education, affordable health care, safe communities, and a clean environment for all of our residents. Please accept my donation in the amount of:

 
___ $25 ___$50 ___ $75 ___ $100* ___ Other: _____

*A donation of $100 or more makes you a member of the “Chairman’s Circle.”


FIRST AND LAST NAME:

MAILING ADDRESS:


E-MAIL ADDRESS:

HOME PHONE:

WORK PHONE:

OCCUPATION:

EMPLOYER:


Please send this form with a check or money order made out to
“Davidson County Democratic Party” to:
Davidson County Democratic Party, P. O. Box 1773, Lexington, NC 27293