Personal Information
Contribution Information
First Name *
 Last Name *
Amount *
$10
$25
 $50
$100
Address  *
Other
$2300
$250
$1000
Payment Information
Card Number  *
State *
 Zip Code  *
City  *
Card Expiration  *
Phone Number  *
Eligibility
Email *
* I confirm that the following statements are true and
accurate:
- I am not a foreign national who lacks
permanent residence in the United States.

- I am not a Federal government contractor.

- This contribution is made from my own funds,
and not those of another.

- This contribution is not made from the funds
of a corporation or labor organization.

- This contribution is made on a personal
credit card or debit card for which I have the
legal obligation to pay, and is not made either
on a corporate or business entity card or on
the card of another person.

- I am at least eighteen years old.
Please add me to your email list!
Employer Information
Employer  *
 Occupation  *
To comply with Federal law, contributors are required to provide their employment
information. If you are retired, please enter N/A under Employer and Retired under
Occupation ; if a homemaker, please enter N/A - Homemaker; if self-employed, please
enter "Self-Employed" under Employer and describe your line of work under
Occupation.
Federal election law requires political committees to use best
efforts to report the name, mailing address, occupation, and
name of employer of individuals whose contributions exceed
$200 during an election cycle. An individual may not
contribute more than a total of $2300 per election to the
committee. Federal law prohibits contributions to the
committee from the general treasury funds of a corporation,
labor organizations or national banks (including corporate or
other business entity credit cards), from any person contributing
another's funds, from a Federal government contractor, or from
a foreign national who lacks permanent resident status.
Contributions are not deductible for Federal income tax
purposes.