Thank You for Your Donation
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Donor Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
My Donation must be below $1,000.00
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Description
Contribution rules
I am a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder).
This contribution is made from my own funds, and funds are not being provided to me by another person or entity for the purpose of making this contribution.
I am making this contribution with my own personal credit card and not with a corporate or business credit card or a card issued to another person.
I am at least eighteen years old. I am not, nor am I making this contribution on behalf of, a corporation, labor organization, national bank, foreign national without a green card, a federal contractor, or any other federally impermissible source.
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