Larimer County Democratic Party: Annual Picnic

2010 Annual Picnic Reservation Form

Saturday, August 28, 2010, 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 - Children 12 and under FREE)

	Guests' Name	Child 12 or under
Your name (required)
Additional Guests:

Additional Comments

Larimer County Democratic Party
606 S. Mason Street, Fort Collins, Colorado 80524
(970) 689-6391 | ldems@frii.com