SUPPORT THE FIGHT TO ELECT
CONSERVATIVE CANDIDATES

Confirm your eligibility

By checking this box, I certify that the following statements are true and accurate:

  1. This contribution is made from my personal funds and is not drawn on an account maintained by a corporation, labor union, or national bank; and
  2. I am a U.S. citizen or lawfully admitted permanent resident and this contribution will not be reimbursed by another person.
Your Full Name:
(as it appears on your credit card)
*

Billing Address:
Street Address:
*
City: *
State: *
Zipcode: *
Phone Number:
Fax Number:
E-Mail Address: *

Required fields for all donations are marked with an asterisk (*)


Occupation
Employer

$10 $25 $50 $100
$250 $1000 $2500 $5000
Other $. *
Please enter numbers only, no decimal points or commas.
 
I want to donate the above amount:
One-Time
Weekly (every 7 days)
Bi-Weekly (every 14 days)
Monthly (every 30 days)
Bi-Monthly (every 60 days)
Quarterly (every 90 days)
 

Credit Card Number:
(Please enter numbers only,
no dashes or other punctuation)
*
Credit Card Expiration Date: Month * Year *
Credit Card CVV Security Code:
(What's this?)
*

I have read and agree to the Donation Policies below.

You will have the opportunity to review your donation details on
the next page before your credit card is charged.


By law, the maximum amount an individual may contribute is $5,000 per calendar year. Contributions are not tax deductible as charitable contributions for federal income tax purposes. Federal law requires us to obtain and report the name, mailing address, occupation and name of employer for each individual whose contributions aggregate in excess of $200 per calendar year. Contributions by corporations, foreign nationals (non-green card holders), labor unions, federal government contractors, and minors under the age of 16 are prohibited.


Security, Privacy, Refund & Recurring Donation Policies

VISA MC AMEX DISC
Paid for and authorized by Conservative Majority PAC