Volunteer Form

Text Box: YES, I want to help Kirk Perkins in his campaign for County Commissioner! Here is my contribution of: □ $1,000 □ $500 □ $250 □ $100 □ $50 □ Other _________ Make checks payable to: Kirk Perkins for Commissioner I can: □ Display a yard sign □ Send letter to editor □ Help put up signs □ Telephoning □ Write personal postcards □ Work polls on election day □ Other _______________________________________________ Name____________________________________________________________________________ Address__________________________________________________________________________ Telephone___________________________Email________________________________________ Profession/Employer*______________________________________________________________ Mail to: Kirk Perkins for Commissioner, PO Box 580, McLeansville, NC 27301 *North Carolina Law requires political committees to report the name, address, job title or profession and employer or employer’s specific field for individuals whose aggregate contribution exceeds $50 in an election cycle. Corporate contributions are prohibited. Political contributions are not tax deductible.

Text Box: If you would like to help with Kirk’s campaign for county commissioner, please print out the form below and return it by mail or email Kirk at the link above. Thank you for your support!

To contact us:

Phone: 336-697-9832

Fax: 336-697-8809

Email: kperkins@triad.rr.com

Kirk Perkins for Commissioner

PO Box 580

McLeansville, NC 27301

Paid for by Kirk Perkins for Commissioner

Kirk

Perkins

COMMISSIONER