Please mail this form with your
check to:
LEBANON COUNTY DEMOCRATIC COMMITTEE
PO Box 1128, Lebanon, PA 17042
Tickets will not be sent to you. Your tickets
will be held at the door.
Please reserve ____ tickets at $40 each, for a total of
$_______
or _____table/s for 10 at $375 each, for a total
of $_______
I can’t attend, but I would like to contribute $____ to
the party.
Name:
_______________________________________________________
Address: __________________
City, State and
Zip____________________
Occupation and Employer:
_______________________________________
Donations are not tax deductible. Corporate
checks cannot be accepted. Labor Donated.