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We need your signature in order to use your name as an endorser! Also, your financial and volunteer support would be much appreciated. Please print out and mail this form to:

Committee to Elect Dick Doubrava
PMB 330, 849 Almar Ave.
Santa Cruz, CA 95060

Dick, add my name to your list of supporters!

Signature _____________________________________

Name: ________________________________________

Address: ________________________________________

 City: _____________________ State ____

ZIP _________

Phone: ______________________

My contribution is enclosed:

___ $25   ___ $50    ___ $100   ___ $250   Other $ ___

___ I need a yard sign

I can volunteer my time for:

___ Phoning ____ Mailings  ___ Walking my neighborhood

___ Posting yard signs    ___ Office Work  ____ Data Entry

___Fundraising   ___ Hosting an event  ___ Other

 

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