Larimer County Democratic Party: Annual Picnic

2011 Annual Picnic Reservation Form

Saturday, September 10, 2011, 4:00 - 7:00 pm
324 Jackson Ave, Fort Collins

Colorado state law requires that all donors who contribute $20 or more include their name, address, occupation, and employer with the donation.

Political contributions are not tax-deductible.

Name:

(required)

Address:

(required)

Occupation:

(required)

Employer:

(required)

E-mail address:

(required)

Phone Number:

(required)

Picnic Guests' Name
(Picnic is $20 each - Active Military/Student $10 - Children 12 and under FREE)

	Guests' Name	Student/ Active Military
Your name (required)
Additional Guests:

Additional Comments

Larimer County Democratic Party
606 S. Mason Street, Fort Collins, Colorado 80524
(970) 689-6391 | info@larimerdems.org
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