Please print the form below and mail it with your donation. Make check or money order payable to: Bristol Virginia Democratic Committee.
Sincerely,
Catherine Brillhart, Chair
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Bristol Virginia Democratic Committee
P.O. Box 1327
Bristol, Virginia 24201
Name: _________________________________________________________________
Address: _______________________________________________________________
Phone: _________________________________________________________________
E-mail: _________________________________________________________________
____________Personal Gift
____________Sponsor ($100)
____________Patron ($75)
___________ Supporter ($50)
____________Donor ($25)
____________Friend ($10)