Elect Tony Core Commissioner

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Contribute by Check

Use your browser's Print function to print out this page. Fill out the necessary information and enclose this with your check made payable to the Core for Commissioner Committee . Send to:

Core for Commissioner Committee
3339 Co. Rd. 20
Rushsylvania, OH 43347

Contribution Amount Enclosed (choose one):

$10

$25

$35

$50

$100

$250

$500

Other:$__________

Full Name:

____________________________________________

Street Address1:

____________________________________________

City:

____________________  St: _________  Zip: ________

Employer2:

____________________________________________

1 Please include number and street, not a post office box.
2 Or occupation if self-employed.

Please note:
Contributions are not tax deductible for federal income tax purposes. Corporate contributions are not permitted. State law requires that we ask the name, address, name of employer (or occupation if self-employed) for each individual whose contribution exceeds $100.

Paid for by the Core for Commissioner Committee, 3339 Co. Rd. 20,     Rushsylvania, OH 43347, Nancy Wisse, Treasurer