OBAMA FOR AMERICA

ALONG WITH HONORARY EVENT CO-CHAIRS

GOVERNOR ANDREW M. CUOMO SENATOR CHUCK SCHUMER SENATOR KIRSTEN GILLIBRAND

INVITE YOU TO JOIN

FOR THE RE-ELECTION CAMPAIGN INAUGURAL GALA DINNER

WEDNESDAY, APRIL

27TH, 2011 AT 6:30PM

AT THE WALDORF ASTORIA STARLIGHT ROOF

301 PARK AVENUE  NEW YORK CITY (BETWEEN 49TH AND 50TH STREETS)
** PLEASE NOTE, DUE TO U.S. SECRET SERVICE REQUIREMENTS ** ALL GUESTS MUST ARRIVE NO LATER THAN 6:30PM

TO RSVP OR FOR MORE DETAILS, PLEASE CONTACT NEWYORKDINNER@BARACKOBAMA.COM OR (202) 572-5451

HTTPS://MY.BARACKOBAMA.COM/APRIL27DINNER?CUSTOM1=SALLY+MINARD

Paid for by Obama Victory Fund 2012, a joint fundraising committee authorized by Obama for America and the Democratic National Committee.

NY362

Yes, I would like to attend the Gala Dinner on April 27th:
 $2,500 per person  $5,000 per person – Premium Seating  $10,000 per person – Photo Reception & Dinner

Yes, I would like to join the Host Committee:
 Host–write/raise $25,000 (includes Photo Reception, Program Listing, Dinner)  Trustee–raise $50,000 (includes VIP Reception, Photo Reception, Program Listing, Dinner)  Chair – raise $100,000 (includes Podium Acknowledgment, VIP reception, Photo Reception, Program Listing Dinner)
** If you are interested in joining the Host Committee, please contact NewYorkDinner@barackobama.com or (202) 572-5451.

If purchasing multiple seats, please list the names of your additional guests: ________________________________________________________________________ I am unable to attend, but would like to support the DNC with a contribution of $ _______ I was invited to attend by _________________Sally Minard_____________________
Obama Victory Fund 2012 does not accept contributions from currently registered federal lobbyists, registered foreign agents, political action committees, or minors under the age of 16. Corporate and labor union contributions are prohibited. Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and employer of individuals whose contributions exceed $200 in an election cycle. First & Last Name: __________________________________________________________________________________________ Address: __________________________________________________________________________________________________ City/State/Zip: _____________________________________________________________________________________________ Employer: ___________________________________________Occupation: ___________________________________________ Work Phone: _________________________________________ Work Fax: ____________________________________________ Home Phone: ___________________________________ Email: _____________________________________________________ Federal law prohibits foreign nationals, except lawfully admitted permanent residents of the U.S., from contributing to the Obama Victory Fund 2012. By signing below, I certify that I am a U.S. citizen or legal permanent resident of the U.S. The funds I am donating are not being provided to me by another person or entity for the purpose of making this contribution, and that my contribution shall be allocated as stated below.

Signature: _____________________________________ Name (Print): ____________________________________
Contribute by Personal Check: Please make your contribution payable to the “Obama Victory Fund 2012” and mail with this completed form to: Attn. Brad Thompson 430 South Capitol St. SE, 3rd Fl Washington, DC 20003 Or fax this form to (202) 572-7854 Or contribute online at: https://my.barackobama.com/April27Dinner?custom1=Sally+Minard For questions, please contact NewYorkDinner@barackobama.com or (202) 572-5451 Contribute by Credit Card:  Visa  American Express  MasterCard

Card Number: ____________________________________________________________________ Exp: ___________ Name on Card: ___________________________________________________________________________________
Contributions or gifts to Obama Victory Fund 2012 are not tax deductible. Contributions to Obama Victory Fund 2012 will be allocated as follows: The first $2,500 of each contribution from a person will be allocated to Obama for America and will be considered designated for the primary election. The next $2,500 of each contribution from a person will be allocated to Obama for America and will be considered designated for the general election. The next $30,800 of each contribution from a person will be allocated to the Democratic National Committee. Any contributor may designate his or her contribution for a particular participant. The allocation formula above may change if any contributor makes a contribution that, when allocated, would exceed the amount that the contributor may lawfully give to any participant.

Signature: _______________________________________________________________________________________

Paid for by Obama Victory Fund 2012, a joint fundraising committee authorized by Obama for America and the Democratic National Committee.

NY362

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