Illinois Campaign for Political Reform
Paper Donation Form

Print this page to mail with your contribution.

__	$250	Patron	Name:________________________________ E-Mail:________________________________ Address:______________________________ City, State, Zip:_________________________
__	$100	Sponsor
__	$50	Friend
__	$25	Individual
__	$15	Student/Senior
Other amount: $____

If Contributing by Check:

Please make your check payable to The Illinois Campaign for Political Reform, and mail to:
ICPR, 325 W. Huron Ave., Suite 500, Chicago, IL 60610

ICPR is a nonpartisan 501(c)(3) organization and donations are tax-deductible to the fullest extent permitted by law.

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