Breakfast with Willie at Norma's Cafe
1123 West Davis
Dallas, TX 75208
Registration:$25.00 per Person
Name:

Number of Persons: 1 2 3 4 5

Title:      *First Name:                 *Last Name                Suffix:      
Mr. Mrs. Ms. None              Sr. Jr. None

Address:
*Type: Home Business Work     *Street: Unit/Apt:
*City:  *State:       *Zip:

Physical Address

(please enter if primary address is a PO Box):
Type: Home Work            Street: Unit/Apt:
City:    State: Zip:       

Additional Information:

Phone Type:                        Area/Phone/Extension:
Home () ext.                              

*Email:                                  *Occupation:                    *Employer:
                     
If self-employed, please enter the name of your business

*

Contributor Information

If you contribute more than $200 to a committee, the committee is required to use its best efforts to collect and publicly disclose on a financial report your name, address, occupation and employer, as well as the date and amount of your contribution. Committees sometimes request this information even for smaller contributions, since the $200 reporting threshold applies to your total contributions to one committee during a calendar year. For example, you may make several small contributions to a committee during a year. Once these contributions add up to over $200, the committee must report the contributor information.

Note that if you collect and forward contributions to a committee, you must transmit them within a specified period of time and must also provide the committee with certain information on the contributors. Additionally, you may have reporting obligations. 

Contribution Eligibility

Paid Political. Adv. by Willie Carter for President Committee. Artisia Price - Treasurer, P.O. Box 3236, For Worth TX  76113

Contribute