Beruflich Dokumente
Kultur Dokumente
___ Yes, I would like to attend the reception at the Buffalo and Erie County Historical Society.
Please reserve ___ tickets at $1,000 per person.
___ Yes, I would like to attend the reception and dinner. Please reserve ___ tickets at $25,000 per
couple (contribute or raise).
___ Unfortunately, I cannot attend, but please accept this contribution of $__________ to show my
support for the 2010 Republican Senate elections.
Guest Name(s):
Please make all contributions payable to the National Republican Senatorial Committee
Anthony Gioia 55 Meadow Road Buffalo, NY 14216 202-544-3464 fax
All contributors please complete this form. 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 aggregate contributions exceed $200 in a calendar year.