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Reception in support for Aneesh Chopra 

Sunday 14 April 2013, 12:00 - 14:00

 

   

 

Please Join
Ranapratap Chegu & Anjan Chimaladinne USINPAC


(host committee in formation)
for a reception in support of


Aneesh Chopra


Candidate for Lt. Governor of Virginia


Sunday, April 14, 2013


12:00 – 2:00 PM


Home of Ranapratap Chegu
663 Nalls Farm Way
Great Falls, VA 22066


For more information or to RSVP click here
or please contact Ranapratap Chegu at This email address is being protected from spambots. You need JavaScript enabled to view it. or (703) 786-6262
or Zach Heinselman at This email address is being protected from spambots. You need JavaScript enabled to view it. or (703) 468‐1341


Suggested Contributions:
Host: $1,000 |Sponsor: $500 |Friend: $250 |Guest: $100
Learn more about Aneesh: http://on.fb.me/Li8Rbc


Facebook (facebook.com/apchopra) & Twitter (@aneeshchopra)
Contributions to Chopra for Virginia are not deductible for federal income tax purposes.

 

Chopra for Virginia
April 14th Great Falls Reception


_____ Yes, I/we would like to attend the reception, enclosed is my contribution of $________
_____ No, I/we are not able to attend, please accept a contribution of $ _________
Please make your contribution payable to “Chopra for Virginia” and mail to:
Chopra for Virginia
PO Box 100459
Arlington, VA 22210
Virginia law requires all candidate campaign committees to maintain a record of the name, mailing address, employer or principal business and occupation for each individual who contributes to our committee.
Name: ________________________________________________________________________
Occupation: ___________________________________________________________________
Employer or Principal Business: ____________________________________________________
City and state of employment or business: __________________________________________
Home Address: _________________________________________________________________
City, State, Zip: _________________________________________________________________
Work Phone: _______________________ Home Phone: _______________________________
Email: ________________________________________________________________________
If you prefer to pay by credit card, please complete the following:
Credit Card Type: Visa _____ MasterCard _____ American Express _____
Account number__________________________________________ Expiration Date_________
Name as it appears on card: ______________________________________________________
Foreign nationals, except legal permanent residents of the U.S., are prohibited from contributing to Chopra for Virginia. Please certify the following information is true and accurate by signing this form: I am U.S. citizen or a permanent resident alien.
Signature____________________________ Name (print)______________________________
Contributions to Chopra for Virginia are not deductible for federal income tax purposes.

Location Home of Ranapratap Chegu, 663 Nalls Farm Way, Great Falls, VA 22066
Contact Ranapratap Chegu at This email address is being protected from spambots. You need JavaScript enabled to view it. or (703) 786-6262 OR Zach Heinselman at This email address is being protected from spambots. You need JavaScript enabled to view it. or (703) 468-1341

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