I Want to Help Re-Elect Alberta Darling to the State Senate!

[ ] I endorse Alberta Darling.  Use my name publicly as a supporter.

Enclosed is my contribution of:
(Payable to Friends of Alberta Darling)

[    ]    $1,000 [    ]    $500 [    ]    $250

[    ]    $100 [    ]    $50 [    ]    $25

Other $ .

I would like to . . .

[    ]  Take a Yard Sign [    ]  Go door to door [    ]  Help to recruit others

[    ]  Help on election day [    ]  Make phone calls [    ]  Help in another way - please call

State elections laws require we obtain the following information.  Please complete each blank, even if not applicable:

Name .

Address .

City, County, Zip .

Home Phone .

Business Phone .

Employer .

Occupation .

Employer's Address .

City    State   Zip .

email .

SIGNATURE .

Please print out this form and mail it to:
Friends of Alberta Darling, P.O. Box 868, Menomonee Falls, WI 53051
Authorized and Paid for by Friends of Alberta Darling, Dave Fantle, Treasurer