CONTRIBUTION FORM
(Please print and mail)

Yes! I believe State Representative Kitty Rhoades possesses the vision and independent leadership qualities that will continue to help make Wisconsin prosper. I am enclosing my  $_______  contribution to support her efforts.

Name:__________________________________________________________

Address:_________________________________________________________

City:____________  St:____  Zip:____________________________________

Phone:__________________________ E-mail:_________________________

Occupation:_________________________ Employer: ____________________________

Thank you!

Please make checks payable to
Kitty Rhoades for Assembly 
P.O. Box 560
River Falls, WI 54022

Contributions are not tax deductible

Authorized and paid for by Kitty Rhoades for Assembly, Colleen Kealy, Treasurer