Thank You For Your Donation

I am grateful for your support and appreciate your contribution.

You can  donate up to $300 per person or $600 per married couple with your personal credit card through our safe and secure site, or you can mail a donation to my campaign.

To send your donation by U.S. Mail, please complete the following form, and enclose it with your check made payable to "Koppen Campaign Committee" to:

Koppen Campaign Committee
1998 Ripley Avenue
Maplewood, MN 55109-4713

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-PLEASE PRINT -

Name: ___________________________________________

Address: _________________________________________

City: ____________________ State: _____ Zip: __________

Phone: (_______)___________________________

E-Mail: ________________________________________

Contribution Amount: $_____ . _____

Occupation:   ______________________________________

Employer:      ______________________________________

Contributions are not deductable for income tax purposes.

Corporate contributions are prohibited by law.