Yes, I want to help my Democratic Club get a local storefront-campaign headquarters ASAP. 

Enclosed is my "Pay The Rent" contribution of $___________

Name: ____________________________________________            Phone No. __________________________________________

Address: ___________________________________________________________________________________________________ 

Email: _____________________________________

Note: ______________________________________________________________________________________________________

Please mail to: Democratic Club of   S.E. Volusia,
PO Box 1531
New Smyrna Beach, FL 32170 

Better yet, bring it to the next Club meeting and drop it in the "Pay The Rent" bowl.