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Support

I will contribute:   

$250

$150

$100

$50

Other

 

I will help as follows:

 

Permit use of my name for endorsement 
Name:

Address:

 
Phone:

Email:

Occupation / Employer:

 

I will:

Hold a coffee

Display a sign in my

home

office

Make phone calls

Be a precinct walker

Provide a testimonial

Do anything else to help