Five Dollar Form

I need your help to qualify for the ballot and funding.

I need 5,295 $5 contributions from registered voters in Arizona to qualify for Clean Elections funding. Any registered voter may contribute, regardless of party affiliation. Each voter must complete a separate form. A married couple must submit two forms. They can give a single check, but they both must sign it.

Please download and fill out the form and send $5 cash or a check payable to VoteDeanMartin.com

Please make sure you complete BOTH the contributor and solicitor sections.

Mail completed forms to: 23227 N. 23rd Place, Phoenix, AZ 85024

Click Here to Download Form:

Call or Email us now at:

602-367-7999

* Denotes required fields

* Email			Request Bumper Sickers:
* First Name			Request Yard Sign(s):
* Last Name			Host a meet & greet:
Fax			Host a fundraiser
Phone			Staff a booth at event
* Address 1			Volunteer at headquarters
Address 2			Drive voters to polls
* City			Distribute literature
State			Setup a speaking appearance
* Zip			Phone people in my area
		Send a fundraising appeal to friends
	Scout for events in your area for Dean to attend
		Knock on doors for the campaign
	Cyberwork (blogging, writing articles, write letters to editors, etc.)
	Notes1
	Notes2
	Notes3

Five Dollar Form

I need your help to qualify for the ballot and funding.

Volunteer

Call or Email us now at:

602-367-7999

volunteer@VoteDeanMartin.com