, , 2007

4 Nov 2008 00:00:00 UTC-0700

Physical Address:
826 A Sreet
Springfield, OR 97477
[VIEW MAP]

Office Hours:
Tuesday and Thursday
9am to noon

Mailing Address:
P.O. Box 11138
Eugene, OR 97440-3338

Phone: 541-484-5099
Fax: 541-762-1081
Email: webeditor@dplc.org

DPLC Bricks & Mortar
Sustainer Program

STEP 1 OF 2 - DONATION FORM

The DPLC Bricks & Mortar Sustainer program helps support your local DPLC office. Our office is the place where we build community and the capacity to win elections. It costs almost $70 a day for us to run the office. We need your commitment to make sure we can continue to have a place where the hundreds of DPLC volunteers that keep us strong can have a place to meet and work; where Democrats, young and old, can come together and learn from each other; where we can be visible within our community; and where we can continue to produce all the effective campaign materials that made the 2006 elections such a success. Your support as a monthly sustainer can help make all that happen. The DPLC can automatically deduct your monthly payment from your debit or credit card.

Please complete all required information on the form below, press the submit button, and then pay with any credit card or your PayPal account at PayPal.com. We use PayPal because they are secure and cost-effective. If possible, use the same name that appears on the credit card or PayPal account you will use.

*Required information

First Name	*
Last Name	*
Address	*
City	*
State	*
Zip	*
Phone	*
Cell Phone
E-mail	*
The following information is required for political contributions:
Occupation (see note below)	*
Employer's Name	*
Employer's Location (City/State)	*
Check this box to confirm that the following statements are true and accurate: 1. I am a United States citizen or a permanent resident alien. 2. I am at least 18 years old. 3. This contribution is not made from the general treasury funds of a corporation, labor organization or national bank. 4. This contribution is not made from the treasury of an entity or person who is a federal contractor. 5. The funds I am donating are not being provided to me by another person or entity for the purpose of making this contribution. * NOTE: Please be as specific as possible with occupation. For example School Administrator instead of just Administrator or Printing Business Owner instead of just Owner. Your contribution is not tax-deductible as a charitable contribution for Federal income tax purposes. Federal Election law requires political committees to report the name, mailing address, occupation and name of employer for each individual whose contributions aggregate in excess of $200 in a calendar year. Your contribution will be used in connection with Federal elections and is subject to the limits and prohibitions of the Federal Election Campaign Act.

YOUR OFF-LINE DONATIONS ARE ALWAYS WELCOME!
You can also make a donation by printing out and completing the Bricks & Mortar Contribution Form.
Send the form with your check to:
Democratic Party of Lane County
P.O. Box 11138, Eugene, OR 97440

DPLC Bricks & Mortar Sustainer Program

STEP 1 OF 2 - DONATION FORM

DPLC Bricks & Mortar
Sustainer Program