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ROB SHERMAN ADVOCACY
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Box 7410, Buffalo Grove, IL 60089-7410
Telephone: (847) 870-0700
Fax: (847) 870-1156
www.robsherman.com
rob@robsherman.com

Financial Supporter
Form for Check or Money Order Contribution

To contribute by credit card, please use our new PayPal feature

Amount of contribution:   $________________________________________________

Project(s) of particular interest to you:    ___________________________________

__________________________________________________________________________

Name:                __________________________________________________________

Address:             __________________________________________________________

E-mail address:   __________________________________________________________

Phone:                __________________________________________________________

Would you like to be listed on our web site as a Supporter?                Yes      No

If yes, would you like to your e-mail address linked to your name?      Yes      No

Would you like to be contacted about being an activist in your community?   Yes   No

Would you like to be contacted in the future with a request for an additional contribution?

      Yes, in one year.      Yes, in three months.      Yes, in one month.

      No. Leave me alone. I'll contact you if I want to make another contribution.

Thank you for your financial support.

Rob Sherman