I Want to Help Re-Elect Joe Leibham to the State Senate!
Name(s)
(Please list your name(s) as
you would like it to be shown for reporting purposes – please print)
Home Address
City State Zip
Home Phone Email
Joe, I/we would
like to help with your election efforts!
Please contact
me/us about:
|
[
] Posting a yard sign |
[
] Database entry |
[
] Helping at parades/events |
|
[
] Scheduling Joe to visit my
service/civic club |
[
] Using my name as an endorsement |
[
] Hosting a fundraiser |
|
[
] Helping with mailings |
[
] Making phone calls |
[
] Submitting letters to the editor |
|
[
] Distributing literature |
[
] Purchasing a T-shirt |
[
] Serving as a Ward Captain |
[ ] Making a financial contribution:
[ ] $25 [ ] $50 [ ] $100 [ ] $500 [ ] $1,000 (max. allowed per person)
State law requires contributions greater than $100 must list occupation, employer and employer address. Business/corporate checks are prohibited by law.
Occupation Employer
Complete Employer Address
Thank you for your
encouragement and support!
Please print out this form
and make your check payable to:
Leibham Campaign Committee
Please mail this form and
your check to:
Leibham Campaign Committee,
Paid for by Leibham Campaign Committee, Ken Leibham, Treasurer