Stonewall Democrats of San Antonio 2009 Awards Banquet
Celebrating Stonewall: 40 Years of Pride & Progress

7:00-10:00PM, Saturday, October 3rd, 2009
Hilton Palacio del Rio, 200 S. Alamo, San Antonio, Texas 78205

 Keynote Speaker: Matt Foreman

Name:

 Address:
Phone Number:

 Email Address:
Tickets.  $75 each.   Indicate number of tickets (____) x $75 = $____________.  Maximum of 10 people per table.  Indicate names below.  If elected official, please include office.  Also, note any dietary restrictions, such as allergies or if you want a vegetarian meal.  Additional names can be listed on the back.
Name:
Name:
 Sponsorships.  This is our major fund raiser for the year, so please consider becoming a sponsor. Sponsors' names will appear in the program.   Please check one of the following:
____Bronze - $100
____Silver - $250
____Gold - $500
____Platinum - $1000
Employment Information
Campaign finance law requires us to collect and report your occupation and employer.
Occupation (If not employed, please enter "not employed".  Complete even if self employed.):


Employer (If not employed, please enter "none".  If self employed, please enter "self".):
Contribution Eligibility
I confirm that the following statements are true and accurate.
  1. I am a United States citizen or a permanent resident alien.
  2. This contribution is made from my own funds, and funds are not being provided to me by another person or entity for the purpose of making this contribution.
  3. I am not a federal contractor.
  4. I am at least eighteen years old.
Initial:  __________
Are you a SDSA member?  Yes / No (circle one)
Make check payable to "Stonewall Democrats of San Antonio - Banquet" and mail to SDSA, P. O. Box 12814, San Antonio, TX 78212.   Check Number:___________   Check Amount:_____________ (tickets + sponsorships)

Stonewall Democrats of San Antonio is a registered Texas Political Committee (GPAC) (http://www.ethics.state.tx.us/dfs/paclists.htm). Your contributions are not tax deductible. Please refer questions to stonewallsanantonio@stonewallsanantonio.org.
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