Member Zone Roads+ Contribution Form Contributions are accepted year round by Roads+. Members in good standing have made a contribution of $50 or more in the current calendar year. If you have questions, please contact Shelby Eva at: seva@micountyroads.org or 517.482.1189. Name * Home Address * Home City, State and Zip * Email Address * Telephone Number * County of Residence * Employer Required unless retired. Occupation/Title Required unless retired. Employer Address Required unless retired. Employer City, State and Zip Required unless retired. Yes, I want to help elect legislators who support better roads and bridges for Michigan! Roads+ Annual Membership requires a minimum contribution of $50. Contribution amount (Please choose one) * Select option... $50 $150 $250 Other If you chose other above, please specify the amount you would like to contribute. Payment Options (Please choose one) * Invoice (will be sent shortly after submission of this form) Credit Card (Fill out form below) Credit Card # Expiration Date CVV Code Please select if you would like this card kept on file for automatic annual renewals. * Yes No
