McHenry County Democratic Party Donation Form:
First Name: Last Name: Address:



City: State: Zip:



Home Phone Cell Phone E-Mail



  Your Donation Amount: $
State law requires us to obtain your occupation and employer for all donations greater then $500.00.
Thank you for your donation and your cooperation.
Occupation Employer
A copy of our report is, or will be,
filed and made available for purchase from the
State Board of Elections, Springfield, IL.
State law requires that we report
the occupation and employer
of any individual who
contributes over $500.00.
Contributions are not tax deductible.;