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Common Cause in Wisconsin

Donation Form
Name(s) _____________________________________________________________________
Address _____________________________________________________________________
City ________________________________ Zip ___________________________
Email ________________________________________________________________
Please send me CC/WI updates by email.
Note: We will not share your email address with others. You may unsubscribe at any time.

Donation Amount: $ _____________

Make your voice heard.


Join Common Cause in Wisconsin today!
Annual Membership Dues:
Individual - $25 Family (two names) - $40 Student - $15 (Circle one)

Membership: $ _____________

Total: $ ________________

Payment method:
Check enclosed. (Please make checks payable to: COMMON CAUSE and DESIGNATE
WISCONSIN IN THE MEMO LINE OF THE CHECK.)
Charge my :

Visa

MasterCard

Card Holder Name:_________________________________________________


Card Number:_____________________________________________________
Expiration Date: ____________ / __________ (Month/Year)
Signature: ________________________________________________________
Please fill out this form and mail it with your donation and/or membership fee to: Common Cause in
Wisconsin, P.O. Box 2597, 152 W. Johnson, #212, Madison, WI 53701
Thanks so much for your generous support!

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