Please Join

President Bill Clinton

for a reception in support of
Congresswoman
Carolyn Maloney
Monday. July 20
th
, 2009
6:00pm to 8:00pm
The St. Regis Hotel
2 East 55
th
Street
New York City
Chairs' Reception with President Bill Clinton from 6:00pm to 6:30pm
For further information, to join the host committee, or to RSVP, please contact:
Carl Silverberg 202320-9797 or carl@silverbergassociates.net
Join the Host Committee
I would like to ;oin the Host Committee as a:
o Chair: Pledge 10 raise $48,000* (Includes 2 ticket5 for Chairs' Reception and program listing)
o Co-Chair: Pledge to raise $24,000* IlncluM5 2 tickets for Chairs' Reception and program listing)
o Patron: Pledge to raise $10,000* (Name listed in event program)
o Sponsor: Pledge to raiseil'.ontribule $4,800* (Name listed in eveut program)
o Friend: Pledge to raise/contribute $2,400* (Name listed in event program)
ol$ubjeCI to Federal Campaign Finilll\,'C ('onlributlon limits
Please list my name on the event program as**: m __m - OR - 0 Do not li.,t my name

Make a Contribution
o Iiwe will attend the July 20
ili
event. Enclosed is my contribution of:
0$4,800 0$2,400 0$1,000 OOther: $ for __.__ticket(s)
Minimum: Sl,OOO/person
Name(s) -
o I/we cannot attend, but have enclosed my contribution of $ .
The following injiJrmation is /'equb'ed by Federal Campaign Finance law:
810to: _
Namc: _
Home Address: . _
City: _
Employer's Name: . .__
Zip Code: . _
Occupation:
Please provide tAe jiJllowing information so we can contact you, ifnecessary. This information is for in/er'nal purposes only and will
!1Q!. appe.ar in reqUired public disclosure filings.
Telephone No, (H): No. (W):_,
Fax No.: .m __ address: .
Please indicate ifcontribution is being made by: 0 Cash o Check o Money Order o Credit Card
Card Number:
Please charge my: 0 Visa 0 MasterCard 0 AMEX 0 Di.cover
______ Exp. Date
The: account being used to make this contribution is registered to and managed a/an:
o Individual 0 Federal Candidate Committee 0 Partnership 0 PAC
For nOffindivlduals please provide the contributing entity's nome: ,_ mm m .... ' __m.
All Host Conmlittee names received by July 16"' will be included on the event program.
Please make checks payable to: Maloney for Congress
110 D St SE, Suite 312, Washington, DC 20003
Phone: 202-320-9797
Contributions or gills to Maloney for Congress are nol tax deductible. Federalla\\' reiluire, us to u,e our be,t effort' to collect and to
report the nam0, mailing addrt3s,'i, occupation and name of employer 01' individuals whose contributions exceed $200 in an election
cycle. Cor Onlle contributions are im ermi"ible bv federal law.
Fax aid for by the Democratic Con essional Cam ai n Committee and authorized by for Congress.