CAMPAIGN DONATION FORM

(PLEASE PRINT)

(Info required by the SC State Ethics Commission)

First Name_______________________________________________________

Last Name_______________________________________________________

Street Address*___________________________________________________ 

City______________________State_______Zip Code________

Email___________________________________________________

Occupation______________________________________________

Donation amount:

$10___  $20____ $50____ $100___ $200____ $ 300___ $ 400___ $500____ Other_____

Make checks payable to Rick Sarver : for elect Rick Sarver for city council campaign

Maximum donation  by the SC Ethics Commission cannot exceed $1,000

Thank you for your donation and support!

 Please mail donation & form to : 104 9th ave N. Myrtle Beach , SC 29577