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Donation Information
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OTHER: $ 
NOTE:
The minimum donation amount is $10.00
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Are these funds personal or corporate? *
Personal funds preferred. Personal contributions may be used to support political candidates. Corporate contributions may not be used to support political candidates but may be used for political action efforts.
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Donor Comments
Donor Information
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Middle Name
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Organization
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Address *
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State
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Phone *
     
Billing Information
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Organization 
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Address Cont.
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State
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Billing Phone *

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