Bush Altschuler Breakfast 7 25 12
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Republican Jewish Coalition PAC · Chairman Ed Cox
Lolly and Harris Bak · Kenneth Bialkin · Devon and Jay Cross
Nina and Mitchell Davidson · John Faso · Larry Heyman· Alexandra and Tim Jenkins
Beth and Chris Kojima· Eliot Lauer· Lisa Ann and Charles Lefkowitz
Kristina and Bruce Lewin· Steven Millner· Zibby and Andrew Right
Jill and David Robbins· Arnold Sheiffer· Scott Sipprelle
Steve Tenedios· Nanar and Anthony Yoseloff · Laurence Zuriff
Committee in Formation
Cordially invite you to breakfast honoring
Randy Altschuler
Republican, Conservative, and Independence Party Nominee, New York's 1st Congressional District
With Special Guest
Governor Jeb Bush
Wednesday, July 25, 2012
8:00 A.M. - 9:30 A.M.
Women’s National Republican Club
3 West 51st Street
New York, NY 10019
$2,500 Host Committee
$500 per Person
For more information or to RSVP please contact:
events@Randy2012.com or 518-281-6812
Please make checks payable to Randy Altschuler for Congress and send to
1263 Middle Country Road, Middle Island, New York 11953
Or go online to www.Randy2012.com to make a secure online contribution
In the “How did you hear about Randy’s campaign?” field, please note “BUSH”
Paid for by Randy Altschuler for Congress
contribute at the following level:
Host Committee
RSVP at events@randy2012.com or 518-281-6812
Please make checks payable to: Randy Altschuler for Congress
1263 Middle Country Road, Middle Island, NY 11953
Name: Prefix: _____ First: ____________________Middle: _____Last:________________________________
Address: __________________________________________________________________________________
City: _______________________________State: _____________ Zip: ________________________________
Home #: ____________________Cell #: _____________________Work #: ____________________________
Email: ____________________________________________________________________________________
Employer: ___________________________________Occupation: ____________________________________
To donate by credit card please fill in the following information:
Credit Card Contributions: (please check one)
Cardholder Name: ___________________________________________________________________________
Card Number: ________________________________________Expiration Date: ________________________
Amount: $_________Security Code (3 digit code on back of card or 4 digit code on front of AMEX)_______
Required Signature: ________________________________________________________________________
You may contribute through the secured website at www.Randy2012. In the “How did you hear about Randy’s
campaign?” field, please note “BUSH”.
Contributions are not deductible for federal income tax purposes. Federal Election Law requires us to report the
name, address, occupation, and employer for contributions that aggregate in excess of $200 in an election cycle. The
maximum an individual may contribute is $2,500 per election. A couple may contribute $5,000, designated per
person in accordance with the proceeding sentence. By submitting your contribution, you agree that the first $2,500
is designated for the primary, and any additional amount up to $2,500 is designated for the general election. Federal
multi-candidate PACs may contribute $5,000 for the primary and $5,000 for the general election. Contributions from
corporations, labor organizations, federal government contractors, and foreign nationals without permanent
residency status ("green cards") are prohibited. Not printed at government expense.
Paid for by Randy Altschuler for Congress
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