Donation Form

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Employment Information:

Law requires us to ask for occupation, employer and employment information. If you do not have an employer, put N/A or if you are self employed, put self employed.

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If you are mailing a contribution, please make your check payable to
Brenda Pogge for Delegate. and send to:

Brenda Pogge for Delegate.
P.O. Box 196
Norge, VA 23127

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