Joe Shaw for Huntington Beach City Council 2006

Contribution Form

 

By Credit Card

Card Type:   Visa ____    MasterCard ____      AmEx ____     Discover ____

 

Card Number: ____________________        Expiration Date:  ____/____

 

Amount: $_________________

 

Please mail this form to

322 Third St

Huntington Beach CA 92648

or

Contribute online at http://joeshawforhb.com

 

By Check

Please make check payable to Joe Shaw for HB and mail this form to

322 Third St

Huntington Beach CA 92648

 

Federal and local laws require political committees to keep record of name, address, occupation and name of employer.

 

Name:

________________________________________

 

 

Email:

________________________________________

 

 

Address:

________________________________________

 

________________________________________

 

 

Occupation:     

________________________________________

 

 

Employer:

________________________________________

 

 

Signature:

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