Alexi Giannoulias
Transcription
Alexi Giannoulias
You are cordially invited to join Cristina Castro and Laura Fletcher For an evening reception to meet U.S. Senate Candidate Alexi Giannoulias Illinois State Treasurer Thursday, September 24, 2009 7:00 p.m.9:00 p.m. Piper’s Banquets 1295 Butterfield Road Aurora, IL Host: $1,000 Sponsor: $500 Friend: $250 Supporter: $100 Guest: $50 RSVP REQUIRED For more information please contact Sarah Glavin at sarah@alexiforillinois.com or at 312.373.9382. Contributions or gifts to Alexi for Illinois are not tax deductible. Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and employer of individuals whose contributions exceed $200 in an election cycle. Federal law permits contributions from an individual totaling up to $2,400.00 per election, with the primary and general elections considered separate elections. Contributions to the campaign from corporations, labor organizations, and national banks; from any person contributing another person’s funds; from foreign nationals who lack permanent resident status; and from federal government contractors are strictly prohibited. Alexi for Illinois does not accept contributions from currently registered federal lobbyists, corporate political action committees or minors under the age of 18. Paid for by Alexi for Illinois ***Please include this page with your contribution*** AMOUNT: $ ______________ I was referred by: ____________________________________ _____Yes, I want to volunteer Contribute by Personal Check Payable to: Alexi for Illinois P.O. Box 494 * Chicago, IL 60690 Contribute Online https://alexiforillinois.ngphost.com/crmapi/contribute First & Last Name: _________________________________________________________________________________________________________________________________________ Address: ____________________________________________________________________________________________________________________________________________________ City/State/Zip: _____________________________________________________________________________________________________________________________________________ If foreign address provide US passport number: _____________________________________ Employer: _____________________________________________ Occupation: ___________________________________________________________________________________ Work Phone: __________________________________________ Work Fax: _____________________________________________________________________________________ Home Phone: __________________________________________ E‐mail: _________________________________________________________________________________________ I certify that I am a U.S. citizen or legal permanent resident of the U.S. Signature: ____________________________________________________________ Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and employer of individuals whose contributions exceed $200 in an election cycle. Second First & Last Name**: ______________________________________________________________________________________________________________________________ **For joint contributions, contributions will be evenly attributed between names. 2nd Name Employer: __________________________________ 2nd Name Occupation: ______________________________________________________________________ 2nd Name Work Phone: __________________________________ 2nd Name E‐mail: ____________________________________________________________________________ I certify that I am a U.S. citizen or legal permanent resident of the U.S. Signature: ____________________________________________________________ Contribute by Credit Card please fill out below: Please bill my personal credit card: Visa MasterCard AMEX Discover Card Number: __________________________________________________________________________________ Exp: ________________________________________________ Name as it appears on the card: __________________________________________________________________________________________________________________________ Signature:___________________________________________________________________________________________________________________________________________________ 2nd Name Signature, if Joint Account: ____________________________________________________________________________________________________________________ Contributions or gifts to Alexi for Illinois are not tax deductible. Federal law permits contributions from an individual totaling up to $2,400.00 per election, with the primary and general elections considered separate elections. Contributions to the campaign from corporations, labor organizations, and national banks; from any person contributing another person’s funds; from foreign nationals who lack permanent resident status; and from federal government contractors are strictly prohibited. Alexi for Illinois does not accept contributions from currently registered federal lobbyists, corporate political action committees or minors under the age of 18. Paid for by Alexi for Illinois