Maryland Committee to Elect Austin Kathleen M. Otto, Treasurer P.O. Box 121 Brookeville, MD 20833-9900 (301)774-3057					www.electaustin.org kateotto@electaustin.org
Volunteer and Contribution form
Name:	______________________________________		Phones:	(work)	_____________________________
	______________________________________			(home)	_____________________________
Address:	______________________________________			(cell)	_____________________________
	______________________________________		e-mail address:		_____________________________
I would like to help the campaign by assisting in the following  (check all that apply): contribute my time (phone bank, walking the precincts, distributing flyers, etc) contribute my money contribute my name as an endorsement raise funds post a sign on my property and/or business do opposition research do voter registration host an event (coffee, breakfast, lunch, dinner, club meeting, fund raiser) help out some other way
Employer and occupation (required for financial contributors):
______________________________________________________________________________________
Please make your checks payable to:          Maryland Committee to Elect Austin
Please enclose this form and return it to:
P.O. Box 121 Brookeville, MD 20833-9900
Suggested campaign contribution levels are:
Golden Eagle $4,000.00 Inner Circle $1,000 + Platinum $750.00 Gold $500.00 Silver $250.00 Bronze $100.00 Founder $50.00 Supporter $25.00
Thank you.