Donor Information

Federal Law requires political 527s to report name, mailing address, occupation and name of employer for all individuals who contribute in excess of $200 in a calendar year.

In order to calculate your total donations throughout the year, we must record ever donation no matter the size. Only those that are above $200 per year will be identifed to the government.

Please read the following carefully!

By making this donation, I certify that: (1) This contributions is made from my own funds and will not be reimbursed by any other person or entity; (2) This contribution is not made from the treasury funds of a corporation, labor union, or national bank; (3) I am a U.S. citizen or lawfully admitted permanent U.S. resident; and (4) I am not personally a federal-government contractor.

  (* required)

  Name & Address  
* First Name
  Middle Name Initial
* Last Name
* Street 1
  Street 2  
* City
* State
* ZIP/Postal
  Employer Information
* Occupation
* Employer

Click the Submit Button only Once!