YES! I am willing to do the following: (please check all that apply)
host a house party call me, I'm flexible help with mailings
help with phoning will walk door-to-door
literature drop display a yard sign Other
(specify) ______________________________________________________________________

I / We endorse Liz Chavez for Idaho State Representative and you can
use my/our name(s) on official campaign materials and advertisements.

Print name(s)______________________________________

Signature_________________________________________

Enclosed is my contribution of:
Any Amount: $__________ $50 $100 $200 $500 $1,000
Please make check payable to “Chavez for State Representative”.

Name__________________________________________________________________________________
Address ___________________________City________________ State_____ Zip ____________

E-mail__________________________________ Home Phone ___________________________________

Print and Send to:
Liz Chavez for Idaho State Representative
215 Prospect
Lewiston, ID 83501

State Law requires us to use our best efforts to collect and report the name and address of every individual
whose contribution is over $50. Thank you for your assistance!