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167th Consecutive Annual Dinner of the
Wayne County Democratic Party
Ticket Reservation Form

NAME(S)  ___________________________________________________________________________________


ADDRESS __________________________________________________________________________________

E-MAIL _______________________________________  


PHONE (           ) _______ - ___________

I wish to purchase ________ adult tickets at $40 each.

I wish to purchase ________ Student Tickets at $30 per person.

I am sorry I will not be able to attend but would like to purchase __________ student ticket(s)

to be donated to student(s) who might otherwise be unable to attend

 I am sorry I will not be attending but would like to make a donation of $_____________

for the ongoing expenses (office rent, utilities, internet, printing) of the Party

and the support it provides for the Democratic candidates in the 2022 election.

My check for $____________________ is enclosed.

Print and mail this form to


P O Box  1257

Wooster OH  44691

All reservations must be made no later than SEPTEMBER 17, 2002

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