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Committee to Elect Charlotte Brown-Williams
Donation Form
Please Make Checks Payable to:
Committee to Elect CBW Judge
Print, Fill Out, and Mail To:
Committee to Elect CBW Judge
1131 Lynbrook Dr., Charlotte, NC 28211
I want to contribute: _____$500 _____$250 _____$100 _____$50 _____Other
FULL NAME:____________________________________________________
ADDRESS:______________________________________________________
_______________________________________________________________
CITY/STATE/ZIP_________________________________________________
TELEPHONE:___________________________________________________
OCCUPATION:_______________ EMPLOYER:_______________________
REGISTERED NORTH CAROLINA VOTER? ________YES _________NO
EMAIL:________________________________________________________
Thank you for your support!
***North Carolina law requires political committees to record the name, mailing
address, job title or profession, and the name of employer for each individual whose
contribution aggregate is in excess of $50 in an election cycle.
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