Lunch with Senator Doug LaMalfa & Dr.

Frank Luntz
 Host - $3,900 Yes, I/we would like to serve as a Host for the Lunch with Frank Luntz. For my
contribution of $3,900 I will receive 8 tickets for the VIP Photo Reception, book signing, and one
table of 8 for lunch.
 Sponsor - $2,000 Yes, I/we would like to serve as a Sponsor for the Lunch with Frank Luntz. For
my contribution of $2,000 I will receive 4 tickets for the VIP Photo Reception, book signing, and one
table of 8 for lunch.
 Co- Sponsor - $1,000 Yes, I/we would like to serve as a Co-Sponsor for the Lunch with Frank
Luntz. For my contribution of $1,000 I will receive 2 tickets for the VIP Photo Reception, book
signing, and one table of 8 for Lunch.
 Yes, I will attend the Lunch. Please reserve ____ tickets at $75 per person.
 No, I am unable to attend, but will contribute $____________.
Note: All guests will receive and autographed copy of Dr. Frank Luntz’s book
“WIN: The key principles to take your business from ordinary to extraordinary."

The following contributor information is required by law:

Name
Physical Address (No P.O. Box)

City/State/Zip

Phone Fax
E-Mail

Occupation  Retired

Employer
Credit Card Contributions
 Mastercard  Visa  American Express  Discover

Credit Card #
Expiration Date

Is this a corporate card?  Yes  No Corporation Name

Name as it appears on the card

Billing Address (if different)
Authorized Signature

Please makes checks payable to The Doug LaMalfa Committee, #1333755

1282 Stabler Lane, #630-257, Yuba City, CA 95993