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Worth County Republican Party

I would like to support the activities of the Worth County Republican Party. I pledge to make a

contribution of:

  $100    $75    $50      $25      Other:

Please submit this completed form below, make your check payable to “Worth County Republican Party” and mail it to:

Liz Kenison
Treasurer, Worth County Republican Party
1000 Central Ave
Northwood, IA 50459

Contributions to the Worth County Republican Party are not deductible as charitable donations
for federal or state income tax purposes. Contributions by corporations, foreign nationals, federal
government contractors, and minors are prohibited under federal and/or state law.

 

              Name:  

          Address:    

City, State, Zip:    

 Phone Number:    

    Email Address:

      

Copyright © 2008 Worth County Republicans. All rights reserved.
Revised: 07/27/08.