P.O. Box 364

Lamar, Missouri 64759

 

Please make checks payable to: Jack Truman for Congress

 

NAME: ____________________________________

 

ADDRESS: _________________________________

 

CITY: _____________________________

 

STATE: ___________________

 

ZIP: _____________

 

HOME PHONE: _______________________________

 

OFFICE PHONE: ______________________________

 

FAX: _________________________________

 

EMAIL: _______________________________

 

Enclosed is my check in the amount of: $ _______________

 

Any contribution is welcome. Thank you for your support!