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$25

$50

$100

$250

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$2500

Other Amount

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Your information

First Name *

Last Name *

Email *

Phone Number *

Country *

Address *

Unit

City *

ZIP Code *

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Your employer

Law requires we ask for your employer and occupation. If you don't have an employer or are retired, put N/A, and if you are self-employed put "self-employed" in employer and describe your occupation.

Employer *

Occupation *

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Payment information

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Contribution rules

1. I am a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder).
2. 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.
3. 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.
4. I am at least eighteen years old.
5. I am not a federal contractor.

I confirm that the above statements are true and accurate.

Your donation:

$25

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