Pris Hayes Campaign Donations Form

To make a secure donation via your credit card or via PayPal, please fill out the form below and click on the DONATE button at the bottom of the page.

To donate via check, please fill out the form below, click on the PRINT button at the bottom of this page, and send the completed printed form along with your check written to "Pris Hayes" to:

Treasurer
c/o Pris Hayes Campaign
PO Box 852993
Richardson, TX 75085

Your Information - ALL fields must be completed and ALL boxes must be checked.

First Name            Middle Initial
Last Name

Email Address

Email Address (verification)

Phone

Physical Street Address (no PO Boxes, please)

City                                           State

ZIP Code

Mailing Address (if different from above)
City                                          State
ZIP Code

Employer

Occupation

*Is this a corporate or union payment? No

*Are you at least 18 years old? Yes

*Are you a U.S. Citizen? Yes

(Federal law generally prohibits
donations from foreign sources.)

Donations are NOT tax deductible.