Birth Of Freedom Registration
Name:______________________________________________________________________
Address:____________________________________________________________________
City:__________________________________________ State:__________ Zip:__________
Phone:__________________________________________________ Ext:_______________
E-mail:_____________________________________________________________________
*Occupation:________________________________________________________________
*Employer: _________________________________________________________________
* Required only for contributions exceeding $50 per year
Birth Of Freedom: Spring 2009 SessionI cannot attend the 2009 Spring Session but please accept the following contribution: $________[ ] $25 Household
[ ] $15 Individual
(Sorry, we cannot accept corporate checks!)
Make checks payable to:
Constitutional Organization
of Liberty
P.O. Box 822
Lebanon, PA 17042
717-228-7524
Pennsylvania law requires
that we report the name, address, occupation, and employer for each individual
whose contributions
aggregate in excess of $50
in a calendar year. Political contributions are not tax deductible.
No corporate checks can be received.
Federal limit per individual
is $20,000 per year.
The Constitutional Organization
Of Liberty reserves the right to reject any applicant for membership or
to terminate membership
for due cause as determined
by the Executive Committee with a full refund of dues for the respective
calendar year in which
termination occurs.
Paid for by the Constitutional
Organization Of Liberty, Monica Carpenter - Treasurer