Dale Ritchey for Georgia State House Here’s my best contribution: ___$2000 ___$1000 ___$500 ___$250 ___$100 ___$50 ___$25 ___Other: $__________ Name: ______________________________________ Address: ______________________________________ ______________________________________ City: ______________________________________ State: _______________________ Zip: ___________ Occupation: ______________________________________ Employer: ______________________________________ Home Phone (optional): ______________________________________ Work Phone (optional): ______________________________________ E-mail (optional): ______________________________________ Receive a free Official Dale Ritchey Volunteer T-Shirt with contributions of $35 or more, please select size: ___No Thanks ___Medium ___Large ___X-Large ___XX-Large Make checks payable to Friends of Dale Ritchey and mail along with this form to: Friends of Dale Ritchey 3150 Andora Trail SW Marietta, GA 30064 For more info call (770) 426-7926 or go to our web site at www.daleritchey.com. Individuals may contribute up to $2,000 in the 2000 calendar year. State law requires the name, mailing address, occupation, and name of employer for individuals contributing in excess of $100 per calendar year. Contributions are not tax-deductible.