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Individual Contributor Certification Form

GDTC Democrat of the Year 2015 Please specify attendee name(s) IN COMMENT above.

Step 1: Specify Donation       
                                                                                                                Paper Form   (including instructions and definitions)
$75 1 attendee   $150 2 attendees   $225 3 attendees     $300 4 attendees     Other Amount:  $ .        

      Continue to Step 2: Specify Donor Information and Qualification