Mitchell For Supervisor

If you would like to mail in a contribution or send
in your credit card information please
print-out this page and mail to:

Mitchell For Supervisor
8001 San Miguel Cyn Rd, #305
Prunedale CA 93907

Checks should be made payable to:
Mitchell for Supervisor

* Optional information
** Required Information for donations of $100 or more (Agregate)
***Info required for Credit Card Donation Processing

***Name:
_________________________________________
***Address:
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***City, State Zip:
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Daytime Phone:
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*Evening Phone:
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*Email:
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Amount of Contribution:
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***Card Type: Mc/Visa/AmEx/Discover
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***Credit Card #:
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***Name on Card:
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***Expiration Date:
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***CCS (Sec Code):
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**Occupation:
**Employer: