Please join us at the

2013 Jefferson Jackson Dinner
with special guest
Governor Ted Strickland

March 9th, 2013
General Reception: 5:00 p.m.
Dinner: 6:00 p.m.

Georgia World Congress Center
285 International Blvd. NW
Atlanta, Georgia (map)

**For sponsorship opportunities, please email

Name On Credit Card


Federal regulations require that all contributors provide their employment information. If you are not employed, enter 'none' in the occupation and employer boxes.



Number of tickets:

x $200 = $

Friends of the Party:

Gold   $1500 = 6 tickets plus your name in the program $
Silver $1000 = 4 tickets plus your name in the program $
Bronze $500 = 2 tickets and your name in the program $

Order Total: $

Credit Card



Legal Compliance

If you would prefer to contribute by mail,
send a check to:

Democratic Party of Georgia
Attn: Candice Franklin
PO BOX 20442
Atlanta, GA 30325