Contribute by Check

Please print out this page, or provide the following information with your donation:

Name:______________________________

Address:_____________________________

Occupation:___________________________

Employer:____________________________

Donation Amount: __$1675 __$1000 __$500 __$250 __$99 Other $____

Maximum allowable donation is $1675 per person, or $3350 per couple. A donation of any amount is truly appreciated.

Checks should be made out to: Candace Andersen for Supervisor

Mail to: Candace Andersen for Supervisor
PO Box 2114
Danville, CA 94526

FPPC# 1343610