Page 26 - 2022 THA Member Program

THA ANNUAL MEMBER’S MEETING
June 26 - 28, 2022

PLEASE MAKE YOUR PAC CONTRIBUTION TODAY
Tennessee accepts corporate, personal and LLC contributions.
(Use This Form)

Your contribution is critical!

Enter your contribution amount, next to the corresponding level:

President’s Club: $1000 & Up $_______________
Executive’s Club: $500 - $999 $_______________
Director’s Club: $133 - $499 $_______________
132 Club: $132 $_______________
Other Amount: $1 - $131 $_______________

NAME: __________________________________________________________________________________

COMPANY: _________________________________ POSITION:________________________________

ADDRESS: _________________________________________________________________________________

CITY: ___________________________________STATE:______________________ZIP:_____________

CIRCLE ONE: a. Corporate Donation or b. Personal Donation

Payment Information: Check (Make payable to TMHA-PAC) or charge to credit card:

____ MasterCard … ____ Visa … ____American Express

Card Number: _____________________________________________ CVV #___________

Expiration: ____________________

Signature: _____________________________________________________________________

Please mail your THA-PAC contribution to: THA, P.O. Box 569 – Mount Juliet, TN 37121
Credit Card Payment may be e-mailed to Office@tnmha.org or faxed to (615) 255-8869.

[2022 Campaign]

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