Please Join

CONGRESSMAN KEN CALVERT

For An Intimate Luncheon

Wednesday, March 19, 2014

11:30 a.m. VIP Reception 12:00 p.m. Luncheon The Mission Inn Hotel
3649 Mission Inn Avenue Riverside, CA 92501 Host Committee: $2,600 Co-Host: $1,000 Luncheon Tickets: $250 Per Person
For more information or to RSVP, contact Stacy Davis at (949) 474-6930 or stacy@stacy-davis.com
Yes! I would like to be part of the Host Committee$2,600 Includes: A table of 10 for the Luncheon with preferred seating and 5 tickets to the VIP Reception Yes! I would like to serve as a Co-Host$1,000 Includes: 2 tickets to the VIP Reception & 2 tickets to the Luncheon I am unable to serve on the Host Committee, however I would like to attend: Please make reservations for ___ individual(s) at $250 per person No, I/we cannot attend but have enclosed a contribution in the amount of: ___$2,600 ___$1,000 ___$500 ___Other MAKE CONTRIBUTIONS PAYABLE TO: KEN CALVERT FOR CONGRESS AND MAIL TO: 24651 EVEREVE CIRCLE, SUITE 1 LAKE FOREST, CA 92630 OR FAX TO: (949) 305-9919 FEC ID# C00257337 CORPORATE CHECKS NOT ACCEPTED TO CONTRIBUTE BY PERSONAL CREDIT CARD, PLEASE COMPLETE THE FOLLOWING:
Circle One: Visa MasterCard American Express ______________________________________________________________________________________________________________________ Name on Card Signature ______________________________________________________________________________________________________________________ Card Number Expiration Date CSC Amount
My signature verifies that this contribution represents my personal funds and is not drawn on an account maintained by an incorporated entity or other prohibited sources.

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Signature of Contributor Signature of Spouse (if joint account on credit card or check contribution)

FEDERAL LAW REQUIRES US TO USE OUR BEST EFFORTS TO COLLECT AND REPORT THE NAME, MAILING ADDRESS, OCCUPATION AND NAME OF EMPLOYER OF INDIVIDUALS WHOSE CONTRIBUTIONS EXCEED $200 IN AN ELECTION CYCLE

Name Employer Occupation Address Office Phone Mobile Phone

Spouse Name (joint contribution only) Spouse Employer (joint contribution only) Spouse Occupation (joint contribution only) City State Email________ Zip

An individual may contribute up to $2,600 for each election ($5,200 total for both the primary and general elections). Married couples may combine their individual donations with joint checks. Contributions from corporations and contributions from foreign nationals without a "green card" are prohibited under federal law. ~ FEC ID # C00257337
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Paid for by Ken Calvert for Congress Committee