Democratic Party of Middletown Township


	Contribute
	Your contribution is vital to reaching-out and getting our message across to the electorate. Please take two minutes to complete the following information, required by PA Election law. Please enter contribution amount:
	$50 $100 $250 $500 $1,000
	Name:
	Phone#:
	Address:
	City: State: Zip:
	Employer Name/Address, or "Self-Employed":
	You will receive a return envelope in the mail - please use it to remit your pledge. Thank you for your generosity!