Citizens for the Preservation of Woodbury Donation form.
                                                                   

For contributions from individuals only:

Name: ____________________________________________________________________________________________

Employer: _________________________________________________________________________________________
If unemployed please write: NONE

Title/Occupation: ___________________________________________________________________________________

For contributions from all other contributor types:

Name of Contributing Entity: __________________________________________________________________________

Description/Nature of Business: ________________________________________________________________________

Name of Contact Person: ______________________________________________________________________________

Contributor contact information:

Mailing Address: ____________________________________________________________________________________

City, State, Zip: _____________________________________________________________________________________

Residential Phone: __________________________________(optional)

Business Phone: ____________________________________ (optional)

E-mail: __________________________________________(optional)
 

 All contributors must be either US citizens or permanent resident aliens (green card holders). Contributions are not deductible for federal income tax purposes.

Thank you for your support on behalf of the candidates and members of the CFTPOW.
Please print this form, fill in the required information and mail checks or money orders only to the address below.

Please make contributions payable to: Citizens for the Preservation of Woodbury,
and mail to: PO Box 211, Central Valley, NY 10917-0211