Your contribution will help to inform every voter in the 102nd district about my platform. I believe in the principles of Individual Liberty and Limited Government, and I want to help get Ray Ondrusek elected.

Name: Address: City, State, Zip: E-Mail: Phone:

Your personal information will not be disclosed to anyone, except only that which is required by Campaign Finance Reporting law to be reported to the Pennsylvania Department of State; Bureau of Elections, Commissions and Legislation. Please check any activity that you will consider helping with:    [  ] Campaign Committee    [  ] Ballot Access Drive    [  ] Distributing Flyers    [  ] Fund Raising Enclosed is my contribution of:    [  ]$25     [  ]$50     [  ]$75     [  ]$100    [  ]$200    [  ]Other:  $ ____________________ Government Mandated Notices: The Federal Election Commission requires political committees to report the name, mailing address, and occupation and name of employer for each individual whose contributions aggregate in excess of $200 in a calendar year. The IRS requires us to print "contributions are not tax-deductible" on all fundraising appeals. Federal law prohibits contributions to a political committee from: the general treasury funds of corporations, labor organizations or national banks, any person contributing another person's funds, foreign nationals who lack permanent resident status, and government contractors.

Please send this form to: Ray Ondrusek for State Rep. 300 West Park Avenue Myerstown,  PA 17067