Announcing the next AAPS Nevada Chapter meeting-
Saturday October 22, 2011 at 12:00 to 2:00 pm at home of:
Dr. Andrew and Janet Zak
9720 Verlaine Court
Las Vegas, NV 89145
in Queensridge (north)entrance on Alta Ave
Congressional candidate Wayne Iverson, MD will be holding a meet and greet from 10am to noon prior to the chapter meeting. (See information below.) Come early to meet him!
Saturday October 22, 2011
10am to Noon
In the home of
Dr. Andrew & Janet Zak
9720 Verlaine Court
Las Vegas, NV
89145
Contribution Levels:
Platinum: $1,000
Gold: $500
Silver: $250
Individual: $150
RSVP to Dr. Zak: alz31762@aol.com
Dr. Iverson, an internist, has practiced in the San Diego area for over 20 years and is running for Congress in a new district covering Tierrasanta, Poway, La Jolla and Coronado. He is a Reagan Club Member in the San Diego County Republican Party and has been actively engaged at a national level to repeal and replace Obamacare.
(See http://www.wayneiverson2012.com)
Wayne Iverson for Congress Contribution Remittance Form.
(Please, print out and mail to address at bottom.)
I/we will attend on October 22, 2011. Please reserve:
___1 Platinum Sponsorship (two tickets) $1,000
___1 Gold Sponsorship (two tickets) $500
___1 Silver Sponsorship (two tickets) $250
___1 Individual ticket $150
___ I/we cannot attend but will help out with a contribution.
Enclosed is our contribution of $_________
Contributor Information:
Federal Law requires us to use our best efforts to obtain and report the name, mailing address, occupation and name of employer for each individual whose contributions aggregate in excess of $200 in an election cycle. If you are retired or a homemaker, please enter “retired” or “homemaker” for both entries above. If you are not employed, please enter “none” for both. If you are self-employed, please enter “self” for employer.
_________________________ ___________________________
First Name Last Name
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Spouse/Guest First Name Spouse/Guest Last Name
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Email Address
Is this a joint contribution? Yes No
_____________________________________________________
Residence Address:
______________________ ____________ ________________
City State Zip
(_____) ______ _________ (_____) ______ _________
Home Phone Work Phone
(_____) ______ _________ (_____) ______ _________
Cell Phone Fax
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Employer (name of company if self-employed)
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Occupation
Make Checks Payable to “Wayne Iverson for Congress”
Mail to: Wayne Iverson for Congress
P. O. Box 420697, San Diego CA 92142
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