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Join the Santa Clara County Democratic Party for our 22nd Annual Jeffersion Jackson Dinner!
Friday, May 11, 2012
San Jose Fairmont Hotel

No-host general reception 5:30-7:00

Dinner and Program 7:00-9:00pm.
Keynote Speaker: California Democratic Party Chairman John Burton


  • In addition to individual tickets, there are also Table Sponsorships available. View Sponsorship Details.

  • To register by regular mail and pay by check, print out this registration form and mail, with payment to: UDC, PO Box 6806, San Jose, CA 95150-6806.

  • If you are unable to attend, but would like to make a donation, please do so at our donation page.

  • For questions on the dinner, contact Hope Cahan at demdinner2012 AT sccdp.org.

  • All funds raised by this dinner will go to providing the infrastructure for the Santa Clara County Democratic Party to support Democratic candidates and volunteer actvities.
      

    Please fill out the required fields in the form below to reserve your tickets.

    Title: *First Name:
    Middle Initial: *Last Name:
    *Email:
    *Address 1: Address 2:
    *City: *State:
    *Zip Code:
    *Phone: Fax:
    *Occupation:
    *Employer:
    *Type of Ticket:
    View Sponsorship Details    		 *How Many?
    Additional Sponsorship Opporunities:  
                 View Additional Sponsorship Details
    Advertising in the Program:  
                 View Program Advertising Details and Insertion Order Form
     
    Special Dietary Requirements:    Vegetarian:    If you have any special dietary needs, please describe them in the space for comments below.
     
    If you are buying a table(s), please list up to 10 per table who will sit there. Also use this space for any additional comments, such as with which group you would like to be seated.

    * required fields



    When you press the register button, you will be directed to Paypal to make your payment by credit card. You will be directed to Paypal's secure server. You do not need to sign up for PayPal, but will need to provide them with a password to utilize the service. 
    We are required by law to collect all of the information in this form for every person purchasing tickets.

    ***********************************************************************************************************

    Your contribution is not tax-deductible for any income tax purposes. 

    The Santa Clara County United Democratic Campaign may only accept contributions from individuals who are 18 years or older and U.S. citizens or permanent residents. Donors cannot be reimbursed for their contributions. 

    Contributions from individuals, partnerships, unincorporated sole proprietorships, and political and candidate committees registered with the FEC will be deposited into the UDC Federal Account (FEC ID #C00231076), unless otherwise designated. These funds will be used in connection with Federal elections and are subject to the limits and prohibitions of the Federal Election Campaign Act. 

    Contributions from corporations, labor unions, and political committees registered with the California Secretary of State will be deposited into the UDC State Account (FPPC ID #871053) to be used in connection with nonfederal elections. California law permits contributions up to $26,600 per calendar year for use in supporting state elections. There are no limits on contributions used for purposes other than supporting state candidates. 

    Federal election law requires political committees to report the name, mailing address, occupation and name of employer for each individual whose contributions aggregate in excess of $200 in a calendar year. 

    Paid for by the Santa Clara County United Democratic Campaign 
    6950 Almaden Expressway #125, San Jose , CA 95120 

    Not authorized by any candidate or candidate committee.

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