Contribute to the democratic black caucus of florida. make a contribution for change.

NAME _______________________________________

ADDRESS____________________________________

CITY__________________STATE_____ZIP________

EMPLOYER___________________________________

OCCUPATION_________________________________

EMAIL_______________________________________

LEVELS OF CONTRIBUTION
$100.00     Bronze
$250.00     Silver
$500.00     Gold
$1000.00   Platinum
$5000.00   Life Membership

ONE YEAR MEMBERSHIP INCLUDED IN CONTRIBUTION.
Make Check Payable to Democratic Black Caucus of Florida or DBCF.
Mail To: P.O. Box 310584 ~ Tampa, FL  33680
Contributions are not tax deductible for federal income tax purposes.
Paid for by the Democratic Black Caucus of Florida