Committee to Elect JT Wilcox - Online Contributions by eFundraising Connections

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JT Wilcox 2022 Salmon Bake

Saturday, September 10 2022

5pm

Wilcox Farm

40400 Harts Lake Valley Road
Roy, WA 98580

1 Tickets

I'm attending
I just want to contribute

Per Person

$25

This ticket's quantity cannot exceed 500

$ Additional Amount

Total:

$0.00

$10
$25
$50
$100
$500
$9600
$ Other

2 Personal Information

Phone

First Contributor

First Name

Last Name

Company Name

Company Type

Responsible Officer First Name

Responsible Officer Last Name

I agree to the following statements:

Certification that Contribution is Not From a Foreign National
I certify that the entity making this contribution is not organized under the laws of, and does not have its principle place of business in, a foreign country. This contribution is not financed in any party by a foreign national, and foreign nationals were not involved in making decisions regarding the contribution in any way.

I, the Authorized Agent listed above, certify that the entity is making this contribution. This contribution is being made, and this certification is being submitted, as of today.

Joint Address

Address

City

State

Zip

First Contributor

I am retired

Employer

Occupation

Employer City

Employer State

Second Contributor

I am retired

Employer

Occupation

Employer City

Employer State

3 Payment Method

Credit Card Number

MM/YY

Security

My credit card address is different than my home address.

4 Event Details

I plan on attending the event.

# Of Guests

Guest names

Comment

By contributing you agree to the terms and conditions.