CONTRIBUTIONS/ENDORSEMENT FORM

I/we endorse KEVIN SCHAUN SANDERS for U. S. House of Representatives for Florida's 4th Dist., in Kevin's 2000 campaign, and authorize the use of my/our name(s) in any and all advertising, promotions, and campaign literature in support of his candidacy.

Individual(s):________________________________________________________________

Political Action Committee:___________________________________________________

Address:____________________________________________________________________

City:____________________________ State:_____________ Zip:____________________

Telephone: Home(_____)_________________       Work:(_____)_________________

Employer:__________________________ Job Description:_________________________

Date:_________________ Signature: __________________________________________

Email: ______________   Signature:___________________________________________

I WANT TO:

___ Work at your headquarters                           ____ Host a tea or reception

____ Place a yard sign                                         ____ Mail endorsement post cards

____ Put a bumper sticker on my car                    ____ Distribute Campaign Brochures 

____ Work Telephones                                        ____ Host a Fund Raiser                   

____ In-Kind donations_____________________________________________ Value: $___________

Make a "personal" (not business) contribution of: (Individual Limits: $1000.00 per election or $2000.00 total). Must designate $1000 for primary and $1000 for general.

Other: _____  $25____  $50 ____  $100 ____  $250____  $500 ____  $1000 ____  $2000 ____

Check Number:_________ Visa/MasterCard/Discover Number:___________________________          Expiration:____________ Card Holders Exact Name:____________________________________

Authorizing Signature:______________________________________________________________