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

Stars & Stripes Forever PAC (formerly The 2016 Committee) can accept contributions in any amount, even from corporations and limited partnerships because it is a grassroots Super PAC. Contributions are prohibited from national banks, federal government contractors, persons in the name of another, and foreign nationals (other than permanent U.S. residents/green card holders).