TICKET RESERVATION FORM

The Virginia Eighth Congressional District Democratic Committee’s

16th Kennedy-King Dinner
Honorary Host: Congressman Jim Moran
Honoring the legacies of Sen. Robert Kennedy and Dr. Martin Luther King

Friday, September 25, 2009

6:30 PM Reception; 7:30 PM Dinner
Hilton Alexandria Mark Center
5000 Seminary Road, Alexandria, VA 22311

Special Speakers to be Announced

Tickets: $150 per person, $250 per couple, $100 YD
$1,250 Supporter Table; $2,500 Benefactor Table; $5,000 Majority Maker Table
(10 seats per table); cash bar

Please complete the following information, and mail (by Monday, September 14) this completed form with
your check to: Peg Willingham, Dinner Co-Chair, 306 Bishops Court, Falls Church, VA 22046
For more information e-mail (preferred) or call Peg at pwilling6464@yahoo.com or (703) 403-1421

Check made payable to: EDDC (Eighth District Democratic Committee).

Memo line: Kennedy-King Dinner

_____YES I will attend. Enclosed is my check for $__________________ for ____________tickets/table

_____NO I cannot attend, but I’ve included a contribution of $____________________________

List guests’ names here (or attach list): _____________________________________________________

Please seat me/us with my Committee or Magisterial District: _____________________ (please specify)

Your contribution may be used in connection with federal elections and is subject to the limitations and prohibitions of the Federal Election
Campaign Act. Federal law requires EDDC to use its best efforts to collect and report the name, address, occupation, and employer for
individuals who contribute $200 or more in a calendar year. Other contributions will be deposited into the EDDC non-federal account. Virginia
law requires political committees to report the name, mailing address, occupation, employer and location of employment for individuals whose
contributions aggregate in excess of $100 in a calendar year. Contributions are not tax deductible for federal income tax purposes.

Name: ______________________________________________________________________________
First Last

Address: _____________________________________________________________________________
Street City State Zip

E-mail: ____________________________________ Phone #: ________________________________

Employer: ____________________________________ Occupation: ____________________________

Employer Address _____________________________________________________________________

Street City State Zip

Paid for by the Virginia 8th Congressional District Democratic Committee,

www.va8thcddems.org, and not authorized by any candidate or candidate's committee. Margo
Horner, Chair