Yes, I want to help create a pro-business region by supporting the LRC-PAC.
Name________________________________________________
Title_________________________________________________
Company_____________________________________________
Address______________________________________________
Phone________________________________________________
Fax___________________________________________________
Email_________________________________________________
Amount I wish to contribute $______________________________
Payment Method
Personal Check Enclosed___
Bill my personal credit card___
Credit Card Type_________________ Exp Date________________
Credit Card #____________________________________________
Signature________________________________________________
Contributions to LRC-PAC are partially tax deductible on your
State of Michigan income tax return. Consult your tax advisor. Personal Checks only; LRC-PAC cannot accept corporate contributions.
Please return via mail to:
LRC-PAC
P.O. Box 14030
Lansing, MI 48901
Via Fax to: (517) 484-6910
Via Email to: jgreen@lansingchamber.org
