____I am joining the Chadds Ford Democratic Party – suggested Membership Donation $10. _____ I would like to make an Additional Donation of:
□ $10 □ $25 □ $50 □ $100 □ Other $____ _____ I am not joining the Chadds Ford Democratic Party but would like to make a Donation of:
□ $10 □ $25 □ $50 □ $100 □ Other $____ _____I would like to Volunteer
Occupation__________________________________________________________________________________ Interests/Skills________________________________________________________________________________ Make checks payable to the Chadds Ford Democratic Committee and mail to PO BOX 875, CHADDS FORD, PA 19317-0634. Since we expect that most of our communications will be by Email, we would appreciate it if you would provide us with your Email Address. ALL INFORMATION, INCLUDING THE FACT THAT YOU HAVE DONATED, WILL BE KEPT STRICTLY CONFIDENTIAL EXCEPT AS REQUIRED BY LAW
Name:________________________________________________________________________________________ Address:____________________________________________________________________________________ Email:_____________________________________________________________Phone:_____________________ | 
