
Mail-In Donation Form
EA0199
First Name:
Last Name:
Mailing Address:
City, State, Zip:
Email Address:
Phone Number:
Occupation:
Employer:
Although there is no limit on the amount you can contribute to Stars & Stripes Forever PAC, Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and employer of individuals whose contributions exceed $200 in a calendar year. If retired, just put "Retired".
□ Enclosed is my check (to Stars & Stripes Forever PAC) for: $_____________
□ Please charge my credit card in the amount of: $_____________
Credit Card #:
Expiration Date: _______ / _______ CCV# (on back): ________
Mail this completed form, along with your check or money order (if applicable) to:
Stars & Stripes Forever PAC
P.O. Box 1351
Merrifield, VA 22116-1351