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Please print this sheet and mail it in.

YES, I want to be an Informed Voter

Name_________________________________________________________________
Address_______________________________________________________________
City/State/Zip___________________________________________________________
Phone (     )_________________________Email_______________________________

I want to join the:    Detroit/Wayne County Chapter       Southfield/Oakland County Chapter  Macomb County Chapter

Tell us which issues are important to you!

Crime and Public Safety                  Education                           Health Care

Seniors Information                              Transportation                   Working Families

I will help inform voters by:

Distributing literature door-to-door   Making Phone Calls            Hosting a Neighborhood Forum

Hosting a Fundraiser                            Placing a sign in my yard   Working a polling place on election day

Here is my check for $__________________________________

As a community-based, grass-roots organization, we rely on you and other concerned community members for our funding.  Although we are a nonprofit organization contributions to Informed Voters are not tax deductible.

Donations over $20 must be by check and written to Informed Voters of Michigan PAC.  In accordance with the Michigan Campaign Finance Act, we cannot accept corporate checks.

If you are making a donation of more than $100, please complete the following information:

Name:_______________________________________________________________________________

Occupation:__________________________________________________________________________

Employer:____________________________________________________________________________

Business Address:_____________________________________________________________________

Your information will be used solely to meet our official reporting obligations under the Act, and for communications from us to you.  We will not provide your information to any other group or organization without your specific consent.

Please specify if you want your donation to help the:

Detroit Chapter                  Southfield Chapter                Macomb Chapter                  Federal Committee

Note: Federal committee donations help us support candidates for federal offices (i.e., Congress and the Presidency)

Please Click Here to help our federal committee and to comply with Federal Election Commission Requirements.

Thank you for your support!

Contributions may be mailed with this form to:
Informed Voters of Michigan, PAC
P.O. Box 43499
Detroit, Michigan 48243