Contribute

To contribute by check or cash please provide us with your name and address and mail your contribution to:

Citizens for Dan Patlak
113 Berkshire Drive
Wheeling, IL 60090

Checks should be made out to "Citizens for Dan Patlak".

 

Credit Card Contributions

To contribute by credit card, please fill out the form below and click the Donate button.  Once you have filled out the form and clicked the Donate button, you will be taken to PayPal's secure website where you can input Credit Card information.

 
First Name:
Last Name:
Email Address:
Address: *
Address2:
City: *
State: *
Zip: *
Donation Amount: *
If you are donating $500 or more, Employer and Title are required.
Employer:
Title:

If you wish to donate by Credit Card, donations are securely handled by PayPal. You do not need a PayPal account to donate.