WesPAC
And
The Democratic Action Team
Present an evening with
General Wesley Clark
Iraq 2004....what is the impact....is this the defining issue....where do we go from here....
Monday May 24, 2004
Park Avenue Country Club
381 Park Avenue South (corner 27th St.)
Doors Open 7:30pm
Co-Chairs
Stan Davis • Ken Fornataro • Gail Furman • Joan Jarowski • Sarah and Victor Kovner •
Barbara Layton • John Plauche • Jeff Wald • Norah and Brian Weinstein
•
Host Committee (in formation)
Marco Argentieri • Margaret Biedel • Mike Brady • Jan Burke • Anthony Cappo
• Kelly Flynn • Lisa Hamilton • Kristin Henderson • Beatrice Moritz • Ruben Olivas • Cheryl Poling • Manny Rodriguez • Eric Richardson • Joseph Sandberg • Scott Schirick • Chad Silverman • Gordon Suber • Jessica Switzer • Cynthia M. Trigg
___ Yes I will attend the event. Enclosed is my contribution of: $50 $100 $150 $250 $500 $1000 $2000
___ Yes I will attend the event and serve as a Host (commitment to give or raise $500)
___ Yes I will attend the event and serve as a Chair (commitment to give or raise $1,500)
___ I cannot attend but would like to support WesPAC by enclosing a contribution of $______
****Private VIP Reception with General Wesley Clark @ 8:30PM for contributions of $250 and above.
We require the following information per FEC regulations. If your contribution is more than $200 please include your occupation and name of employer.
Name______
Home Address ______
City ______State ______Zip ______Home Phone ______
Work Phone ______E-Mail ______Fax ______
Employer and Occupation ______
To contribute by credit card, please complete the following:
Credit card type (circle one): Visa / MasterCard / AMEX / Discover
Credit Card Number: ______Exp. Date: ______
Name of Cardholder: ______
Cardholder Signature: ______
Billing Address (if different from above): ______
To Reserve Tickets
Credit card contributions may be faxed to Patrick Canavan at (917) 591-4372
Or e-mail completed form to
Checks should be made payable to WesPac with contribution form to:
WesPAC c/o Democratic Action Team 211 E 89th St. Apt. A5 New York, NY 10128
For further information please contact Patrick Canavan (212) 831-9594
Or visit our website @ http://www.democraticactionteam.org/
Contributions to WesPAC are limited to $5,000 per individual per year. Contributions must be made with personal funds and may not be reimbursed or paid by any other person. Contributions by corporations, labor unions, national banks, federal contractors, and non-U.S. citizens who are not lawfully admitted for permanent residence in the U.S. are prohibited.
Contributions or gifts to WesPAC are not deductible for federal income tax purposes.
Printed In-House Referred by:______