Please print this page out, provide the information requested, and mail it along with your personal check. Please make contributions payable to
"Gregory for State's Attorney Campaign" and mail to:
Gregory for State's Attorney Campaign Committee
By authority of: Patrick Thompson, Treasurer
Queen Anne's Building
115 Lawyers Row
Centreville, MD 21617
Yes, I want to help Re-elect Chip! Enclosed is a contribution to help.
Name: _________________________________________________________
Address: _______________________________________________________
City: _________________________ State: ________ Zip Code: __________
Phone: ____________________________ Fax: _______________________
Email: _______________________________________
Occupation: __________________________________
Employer: ____________________________________
Amount enclosed: __________________
Maryland State law permits individuals to contribute a maximum of $4,000 to a political committee in a four year cycle (January 1, 1999 to December 31, 2002).
By authority of: Patrick Thompson, Treasurer
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