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Contribution Page:

Dan
JURKOWITZ
for
JUSTICE
of the Peace

Print form and mail to 7473 E. Broadway, Tucson, Arizona, 85710

 

Enclosed is my contribution for:

\$340 $200 $100 $75 $50 Other:$_____

 

I would also like to help by:

Lending my name for endorsement

Walking my precinct

Posting a sign

Holding a fund-raiser

Making phone calls

*Name:

*Address:

*City: *State:

*Zip Code:

Phone:

E-mail:

*Occupation:

*Employer:

*required by Arizona law