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Welcome
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Personal
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Service
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Independence
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Community
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Calendar
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Support
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Endorsement
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Phone Links
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Welcome
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Personal
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Service
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Independence
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Community
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Calendar
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Support
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Endorsement
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Option 2: To Fax or Snail Mail, just
Print, Sign, and Send Today!
Print Name(s): ____________________/___________________
Signature(s):______________________/___________________
Address:_________________________________
City, ST, ZIP:_________________________________
Tel:(H)____________(O)_____________e-mail______________
Occupation:________________Employer:__________________
Employer's Address:_____________________________
(This information is required by law)
Please check:
__ You may use our name(s) as endorsers.
__ I (we) want to help. Please call me (us)
__ You may put up a lawn sign in my (our) yard
__ Here is my (our) contribution: $__________
City ordinance restricts contributions to a $100 maximum per person.
Please make checks payable to Friends of Jerry Kaneko, ID# 992208 and mail to:
Treasurer, Friends of Jerry Kaneko
2044 Alta Loma St.
Davis, CA 95616
Jerry Kaneko, 556 Reed Dr., Davis, CA 85616 Tel: 756-2324: Fax: 756-0927
e-mail: jkaneko@dcn.davis.ca.us / web: www.dcn.davis.ca.us/vme/jerry
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For More Information...
Please call Jerry Kaneko at 756-2324
or email: jkaneko@dcn.davis.ca.us
or 556 Reed Drive, Davis, CA 95616
or Fax 756-0927
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