Contribute via mail



To contribute via mail, please print and fill out the form on this page or press the button for a printer friendly version of the form. Enclose the form and a check made payable to
Dan Konieczka for Judge.

Mail to:

Dan Konieczka for Judge
1519 Fernledge Drive
Allison Park, PA 15101

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PERSONAL INFORMATION

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CONTRIBUTION

Please select an amount or enter a contribution. In order to comply with Pennsylvania State law, contributors are required to provide their employment information for contributions greater than $250.

                       

EMPLOYMENT INFORMATION

If you are retired, please enter N/A under Employer's Name and Retired under Occupation; if a homemaker, please enter N/A - Homemaker; if self-employed, please enter "Self-Employed" under Employer and describe your line of work under occupation.


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