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YES! Doug, I'd Like to Make A Campaign Contribution!
(Please PRINT this page by hitting the Print Button
on your browser. Then fill out this page and mail it along with your
contribution to the address below. Thank you!)
For a contribution of:
| ____ $10 |
____ $20 |
____ $50 |
____ $100 |
____ $250 (Limit*) |
*Spouses may EACH contribute up to the limit of $250
To Volunteer:
(Check ALL that apply to you)
| ____ Mailings |
____ Walk My Neighborhood |
____ Post Signs |
| ____ Host An Event |
____ Phone Help |
____ I have a place for a sign |
You may use my name publicly, including print and media, as an
endorsement of my candidacy.
Signature ______________________ Date __________
In order to comply with the campaign laws, please complete
the following: (Please Print)
| Name _________________________ |
Address _______________________ |
| City ___________ State__ Zip_____ |
Phone ___________ Bus __________ |
| E-mail ___________@____________ |
Occupation ____________________ |
| Employer Name _________________ |
Business Address ________________ |
| If Self Employed, Name of Business
_________________________________ |
Mail Your Contribution to: Deitch
for Supervisor,
3540 Porter Gulch
Rd., Aptos, CA. 95003
Note: By County Ordinance we can accept personal checks
ONLY. No corporate, partnership, or business checks, please.
Paid for by Deitch for Supervisor. Bruce Smith, Treasurer, ID# Pending, c/o Deitch for
Supervisor, 3540 Porter Gulch Rd, Aptos, CA. 95003, (831) 688-2825, e-mail: ddeitch@pogonip.org
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