Republican Executive Committee
Courtesy Contribution Reply Form
Yes! Tom, I want to help you in your
never-ceasing battle against liberal extremists in the Democrat Party and do my
share in an across the board victory for the Republican Party in 2012.
Please support those Republican
candidates for office that share my conservative views and will fight for clean
and honest government, will fight the politics of failure, and will safeguard
my tax dollars.
To help you do this, here
is my contribution (check made payable to .Indian River REC.) for:
( ) $500 (
)$400
( ) $300 (
) $200 ( ) $100
( ) $_______ Other
Please complete the
information below as we are required to report all
Contributions to the Indian
River
Name:
_______________________________________________________________
Addresss_____________________________________________________________
City:
E-Mail:__________________________________
Phone: _____________________
Occupation: Employer:
________________________________________________
( ) Would you like to receive e-mails about
Please mail your contribution
to:
C/O Tom Lockwood, Chairman
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