Please Print this form, complete it and then mail it with your check to:

Committee to Elect Bill Aboumrad
1141 Catalina Drive
Box 179
Livermore CA 94550

Enclosed is my check for:

____$250.00   ____ $100.00   ____$50.00   ____

Name:

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Address

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City

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Zip

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Email

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Phone

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State election laws require that we collect the following information:

Occupation

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Employer

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