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The 11th Congressional District of Virginia Republican Committee

cordially invites you to join them for a

UNITY DINNER in honor of
our Republican Nominee for Congress
Friday, June 25, 2010
6:30-7:15 V.I.P. Reception 7:30-9:30 Dinner & Program

The Mason Inn Hotel & Conference Center

4352 Mason Pond Drive, Fairfax, VA 22030
$2,400 HOST Reserved Table of 8 for dinner, 8 tickets to VIP reception, full page ad in event program
$1,000 BENEFACTOR 4 dinner tickets, 4 tickets to VIP reception, half-page ad in program
$500 PATRON - 2 dinner tickets, 2 tickets to VIP reception, business card ad in program
$250 SPONSOR - 2 dinner tickets & business card ad in event program
$100 FRIEND - 1 dinner ticket and 50% discount on any size program ad
Individual Tickets - $75 per person

All sponsorship levels include listing in the event program.

Hosts, Benefactors & Patrons will receive Special Recognition at the Event
Donors of $100 or more receive automatic entry into door prize drawing. Need not be present to win.
For more information or to R.S.V.P., please contact Mary Campbell at 703-815-8984 or email:
Please make your check payable to: 11th CD of VA Rep. Comm.
and mail it with this form to: 10412 Main Street, Fairfax, VA 22030
Yes, I/we will attend and wish to support this event and the 11th District Committee by serving as a:
HOST - $2,400 BENEFACTOR - $1,000 PATRON - $500 SPONSOR - $250 FRIEND - $150
Purchase _____ tickets at $75 each I/we would like to place an ad in the event program. Please contact me.
No, I/we cannot attend, but wish to support the 11th District Committee with a contribution of $________.

Name: _____________________________________________________________________________________________________
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Address: ___________________________________________________________________ Phone: _________________________

City/State/Zip: _______________________________________________________________ Email: __________________________

*Occupation: ________________________________________________________________

*Employer & Employer Location: ________________________________________________________________________________

*Federal and Virginia law require us to use our best efforts to collect and report the name,mailing address, occupation, employer and employer location for all contributions.

My/our guests are: Paid for and authorized by the 11th Congressional District of Virginia
Republican Committee (11CD). Not authorized by any candidate or
candidate committee. Contributions are not tax deductible.
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Donations that meet Federal contribution law requirements are deposited to the
11CD Federal account; contributions that do not meet Federal requirements, but
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meet State requirements, are deposited to the 11CD non-Federal account.
For our Federal account, we only accept contributions from individuals or Federal
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PACs. Federal law prohibits contributions to the 11CD from the funds of
corporations, labor organizations or national banks (including corporate or other
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business entity credit cards); any person contributing another persons funds;
foreign nationals who lack permanent resident status; and government contractors.
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Contributions from foreign nationals are strictly prohibited. Any information that
you provide becomes a matter of public record and may be published. However,
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the 11CD respects the privacy of its donors, and discloses only the information
that is required by law or regulation.
Beef Chicken Vegetarian
Fresh Garden Greens
Sliced Cucumbers, Julienne Carrots, Plum Tomatoes & Yellow Tomatoes, Served with Peppercorn Dressing
Choice of:
Roasted Tenderloin of Beef with Cabernet Demi Glace
Served with three-cheese mashed potatoes
~ OR ~
Southern Pecan Encrusted Chicken Breast
Accompanied by Virginian corn souffl
Raspberry and White Chocolate Mousse Crepes
Kiwi sauce with berry garnish
Coffee & Tea

YES! I will place an ad or special message in the 11th District

Republican Committee Program! My check is enclosed for:


Business Card ..................... 2 x 3 (horizontal/landscape only) ...... $50.00
1/2 Page ............................ 3 x 4(horizontal/landscape only) ...... $75.00
Full Page .......................... 4 x 7(vertical/portrait only) ............ $100.00
Inside Front
& Back Covers ................. 4 x 7(vertical/portrait only) ............ $250.00
Outside Back Cover ......... 4 x 7(vertical/portrait only) ............ $500.00

Instead of an advertisement, I wish to have a Special Message inserted into the ad size
indicated above, as follows:
Best wishes to the 11th District Republican Committee for a successful event!
(You may also email your special message)

Electronically transmitted ads are required.

Email your ad or special message to: ...........
Ad design and layout is available at an additional charge. Please inquire.

DEADLINE: Monday, June 21, 2010

For Advertising questions or Technical Assistance please contact:
Becky Stoeckel at: or 703-731-9029
Preferred file formats: Acrobat PDF is best. Or an .EPS with text set to curves/outlines
Note: GIF, JPG or any other low-resolution image should be avoided if possible. Photos/grayscale images should be at 300 dpi.

Acceptable file formats: Illustrator CS (or earlier), PageMaker 7.0 (or earlier), MS Word 2003 (or earlier),
WordPerfect 8.0 (or earlier), MS Publisher 2003 (or earlier), MS Powerpoint 2003 (or earlier) .TIF or Photoshop 8.0 (or earlier).
Note: These file formats may require you to also send your fonts and/or any imported or placed graphics as separate files.