Roccucci

___ YES, I endorse your candidacy for Roseville City Council and you may use my name publicly as a supporter.
___ I want a sign to display in my yard or business
___ I want to volunteer to help your campaign
___ Enclosed is my contribution of $_____________

Signature ________________________________________

Print Name ________________________________________

Address ________________________________________

Telephone _________________________ Email _________________________

Occupation _________________________ Employer _________________________