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First Name:______________________ Last Name: ________________________

Address: __________________________________________________________

City: ____________________________ State: _____ Zip Code:_____________

Phone:_____________________ Email: _________________________________

Contributions/donations are not tax-deductible at this time. The money is used to support our effective, citizen-based advocacy and lobbying efforts. Checks payable to Maine DOP.

THANK YOU!

Mail to: Maine DOP
15 Everett Street, #1, Brunswick, ME 04011
Phone 207-491-5064
www.mainedop.org