Stand Up For Fernley

1380 N. US Hwy 95A, Suite 2- PMB 112

Fernley, NV  89408

Pledge of Support

I agree that I want to “Stand Up For Fernley” and bring a positive and constructive change for our city.

I agree with the goals stated and want to be part of the process of positively working towards solving these goals and finding new goals to accomplish in the future, making Fernley a “Great Place to Live, Work and Play for generations to follow.

I will proudly add my name to those who support “Stand Up For Fernley” and pledge a contribution of $__________.

I acknowledge that this Political Action Committee is not a tax-exempt organization and contributions are not tax deductible according to IRS laws.

As a citizen, I will support the organization at meetings when I can attend and will exercise respect when exercising my freedom of speech at such meetings.

As a business, we will financially support the organization from time to time with contributions or in-kind donations that we can afford.

_______________________________                      _________________________________

                        Printed Name                                                              Signature

_______________________________                      _________________________________

                    Company (If Any)                                                          Date

______________________________     ____________________________   _____  ____________

                        Address                                               City                                  State             Zip

_______________________________                      _________________________________

                        Phone #                                                                       Email

Donations of $100 or more must be reported on disclosure forms, if your donation is less than $100 and you still want to be reported as a contributor, please check here _____.

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