PAC - Pennsylvania Food Merchants Association

Please fill out the form below to make a contribution by credit card or click here to download the form and mail payment.

Contributor Name

I would like to donate to the following PAC: *
First Name *
Last Name *
Title
Address 1 *
Address 2
City *
County *
State *
Zip *
Phone *
Email *
Credit Card Information

Contribution Amount
Please enter the amount in the following format: 2000.00
$5000 limit for Pennsylvania FoodPAC (Federal PAC)

Contribution Guidelines
These amounts are only a suggestion.
All contributions are voluntary.
Executive CEOs and Presidents $2,000 - $2,500
Senior Officers and Vice Presidents $1,000 - $1,500
Assistant Vice Presidents $500 - $1,000
Managers $250 - $500
Administrative Staff $25 - $100

Payment Type

Credit Card Type * MastercardVisaDiscoverAmex

Credit Card Number *

Name On Card
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	Use Address Above
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Phone Number
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Verification

I verify that this is my personal credit card. (Please Initial)

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Please click submit only one time. The transaction may take several seconds.

According to state campaign laws, only individuals and other political action committees are permitted to make contributions FoodPAC contributions are not tax deductible as charitable contributions for Federal Income Tax purposes.

State laws require political committees to use their best efforts to collect and report the name, mailing address, and occupation of individuals who contribute in a calendar year.

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PAC - Pennsylvania Food Merchants Association