Jean Hay Bright

Democrat for U.S. Senate 2006

Peace Jobs Health Care Justice

IF YOU WANT THEM YOU HAVE TO VOTE FOR THEM

Help this Progressive Candidate reach the voters with her message

Campaign Contribution Form

 

Click here for a PDF

Back to Home Page

Name:____________________________________________________________

Street:____________________________________________________________

City:_______________________________ State:_____ ZIP:_______________

Email:____________________________________________________________

Phone:____________________________________________________________

Occupation:________________________________________________________

Employer:_________________________________________________________

I am contributing $________________________Check Number_____________

or Visa/Mastercard Number____________________________ Exp. Date_______

____ Yes, you may post my name as a supporter of Jean’s campaign.

____ Yes, I would like to volunteer to work on Jean’s campaign

____ Yes, I am willing to host a fundraising house party for Jean

 

____  Check here if the all of the following are true.

This contribution will be made from my own funds, and not those of another.

This contribution will not be made from the general treasury funds of a corporation, labor organization, or

national bank.

I am not a federal government contractor, nor am I a foreign national who lacks permanent resident status

in the United States.

This contribution is made in cash, or on a personal check, credit or debit card for which I have the legal

obligation to pay, and is not made on a corporate check or card, nor on the check or card of another.

 

 

Mail your contribution to:

Jean Hay Bright.US Senate 2006

4262 Kennebec Road

Dixmont ME 04932

 

As is the norm for political contributions,

contributions to JeanHayBright.US are NOT deductible for federal income tax purposes.

Authorized and paid for by JeanHayBright.US Senate 2006, David Bright treasurer

4262 Kennebec Rd, Dixmont ME 04932 Bangor 207-234-4224 Portland 207-321-2776

 

Click here for a PDF

Back to Home Page