PRINT THIS FORM.  FILL IT OUT.  MAIL IT IN.




I wish to donate to Tea Party Patriots.


Please charge my credit card in the amount of $__________.


_______________________________________
Credit Card Number


_______________________________________
Expiration Date


_______________________________________
Name on Credit Card


_______________________________________
Address of Credit Card Bill


________________   _______   __________
City               State     Zip


_______________________________________
Telephone Number


_______________________________________
Email Address



_______________________________________
Authorized Signature



MAIL TO:

Tea Party Patriots
1025 Rose Crk 620-322
Woodstock, GA 30189