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Donation

* Mandatory fields
*First name
*Last name
Nick Name
First name for name tags, etc
 

My Mailing Address

Mailing Address
Only if different from your residence address
Mailing Address City
Only if different from your residence address
Mailing Address Zip
 

Residence Address (if different than Mailing Address)

*Residence Street Address
Your residence address that determines your voting precinct
*Residence City
*Residence Zip
 

My other contact information

*Email
*Phone
Mobile Phone
Volunteer Information
List ways you can help
 

Information required by the state for all members

*Employer
Employer City
Employer State
*Amount ($USD)
Comment
 Payment frequency

Security check

* Code
 
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