Bikes Belong Coalition Political Action Committee Participation Form

Submitted by superadmin on Thu, 05/24/2007 - 21:51.

(Federal Election Law requires that this form be on file with BikesPAC)

A PDF version of this form is available for download at the bottom of this page.

Choose

I authorize participation by my company in BikesPAC on the following basis. Please check the option that you approve: *

I authorize BikesPAC to solicit all of our executive and administrative employees (I will provide names and home addresses of these employees for solicitation purposes).

I authorize BikesPAC to solicit our executive and administrative employees, but prefer to designate someone from our company to collect and forward the contributions to BikesPAC rather than provide home addresses for solicitations. I also authorize BikesPAC to invite our executive and administrative employees to BikesPAC fundraising events.

I will contribute directly to BikesPAC and prefer that you do not solicit any other eligible employees.

Contact Information

First Name: *

Last Name: *

Title: *

Corporation: *

E-mail: *

Confirm E-mail: *

Authorizations

Signature 1

Authorize: *

I hereby authorize participation for 2010

Signature: *

type your full name here to indicate your authorization

Date:: Mar/11/2010

Signature 2

Authorize:

I hereby authorize participation for 2011

Signature:

type your full name here to indicate your authorization

Date:: Mar/11/2010

Signature 3

Authorize:

I hereby authorize participation for 2012

Signature:

type your full name here to indicate your authorization

Date:: Mar/11/2010

Disclaimer

* A corporation may not authorize more than one trade association PAC to solicit its employees in a calendar year.

* Contributions or gifts to BikesPAC are not tax-deductible.

If you have questions, please contact Gary Sjoquist at 952/941-9391 x1288 or e-mail gary@bikesbelong.org.

Attachment	Size
Participation form2009-2011.pdf	100.01 KB

Mailing address:

Bikes Belong Coalition
P.O Box 2359
Boulder, CO, 80306

Physical address:

1928 Pearl St.
Boulder, CO, 80302
Telephone: 303/449-4893
Fax: 303/442-2936
mail@bikesbelong.org

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Join Us!

Your membership is an investment in the future of bicycling in America.

Bikes Belong Coalition Political Action Committee Participation Form

Disclaimer

Mailing address:

Physical address:

Best Bets For:

Join Us!

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