CONTRIBUTIONS

You can contribute securely online using our PayPal account, just click here.

Or to send contributions using the U.S. Postal Service, please print this page and mail it with your check.

Federal Law requires us to use our best efforts to collect and report the name, mailing address, occupation and name of employer of individuals whose contributions exceed $200 in a calendar year. Contributions submitted with this form will be used to influence Federal Elections and are subject to the Federal Election Campaign Act. Political Contributions are not deductible for income tax purposes. We cannot accept contributions from Corporations, Labor Unions, Foreign Nationals or in the name of others.

Please provide the following information:

Name ________________________________________

Address ______________________________________

City, State, Zip _________________________________

Occupation ___________________________________

Employer _____________________________________

Contribution Amount ____________________________

Mail to:
Treasurer, Reform Party of the USA
3961 Merrell Rd.
Dallas, TX 75229

Your Support is Always Appreciated!