Name
Home Address
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Business Name
Business Address
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Please provide the following contact information:

State Representative
State Senator

Does either of your legislators know you by name?

Rep
Senator
Both

I understand that this will be a costly battle and would like to help with the expense:

Donate Using: Visa Mastercard Amex Discover    Card Number:    Exp:mm/yy     Amount:.00

All funds raised will be used solely to promote the legalization of EGD’s and full accounting will always be available.