Planned Parenthood VOTES! Rhode Island
PAC Contribution Form
Yes, I want to unite to preserve choice and become a
member of Planned Parenthood VOTES! Rhode Island PAC:
___
$25 Supporter
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$10 Student Supporter
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$50 Advocate
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$100 Activist
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___ Other
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___ I am already a member, but
I want to make an additional contribution
Please make
check payable to: PPVRI PAC
Because your contribution to
Planned Parenthood VOTES! Rhode Island PAC may be used
for political purposes, such as supporting or opposing
candidates, it is not tax deductible. PPVRI PAC cannot
accept contributions from corporations or labor unions.
Name
Street
City State Zip
Telephone
Occupation
Place of Employment
Street
City State Zip
E-mail
Political
action committees in Rhode Island are required by law
to report the above information for each individual
who contributions aggregate of $100 in a calendar year.
Thank you for your cooperation.
Please print this form and mail it with your
check to:
Planned Parenthood VOTES! Rhode Island
PO Box 41059
Providence, RI 02940-1059
If you have any questions, feel free
to call the Community Affairs office at (401) 421-7820 or
e-mail us at contactus@pprimail.org.
Location:
111 Point Street
Providence RI 02940-1059
Mailing Address:
Planned Parenthood of Rhode Island
Post Office Box 41059
Providence RI 02940-1059
(401) 421-7820 Administration
(401) 621-6250 Administration Fax
(401) 421-9620 Health Center
(401) 421-9668 Health Center Fax
(401) 621-6251 Facts of Life Line