Democratic Party of Wisconsin 8th CD

General Donation to 8th CD Dem Party $________ Northern County Information Group (NCIG) $_______

Tri County Influence Campaign (TIC) $_______ Other (describe) ____________________________________ $_______

First Name _______________________________________________ Last Name _____________________________________

Address ____________________________________________________ City ___________________ State ____ Zip ________

Occupation _______________________________ Retired ____ Unemployed _____

Make Check Payable to ‘Dem 8th Congressional District’.

Please put note in memo area of check if General, NCIG, TIC or Other.