2011 NCGOP Hall of Fame Banquet

Sponsorship Form
CO-HOST SPONSOR $2,500
METHOD Check

HOST $5,000 $2,000

RECEPTION SPONSOR $1,000

OF

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________________________________ ________ /________ Account # Exp. Date ________________________________ _________________ Signature Amount _____________________________________________________ Name on Card

Name Mailing Address City, State & Zip Home Phone Cell Occupation PLEASE RETURN TO: Office Phone Email Employer NCGOP Hall of Fame Post Office Box 12905 Raleigh, NC 27605 Jennifer Behr, Finance Director (919) 828-6423 behr@ncgop.org

CONTACT:

Paid for by the North Carolina Republican Party. 1506 Hillsborough Street, Raleigh, NC 27605 www.ncgop.org Not authorized by any candidate or candidates committee. Contributions to the North Carolina Republican Party are not deductible as charitable contributions for federal income tax purposes. Contributions from corporations and foreign nationals are not permitted. Funds received in response to this solicitation will be subject to federal contribution limits. Federal law requires political committees to use their best efforts

to obtain and report the name, mailing address, occupation and employer for each individual whose contributions aggregate in excess of $200 in a calendar year.