Recurring Donation

We are required by law to use our best efforts to collect and report the name, mailing address, occupation, and employer of each contributor who gives more than $200 in a calendar year.

Full Name *

Last Name *

Email Address *

Phone *

Occupation *

Employer *

Current Address *

Apt, Suite, Unit, Etc (Optional)

City *

State *

Zip Code *

Acknowledgement: *

I acknowledge that contributions to this organization are not tax deductible.

Affirmation: *

By clicking this button, I certify that I am at least 18 years old and am making this contribution on a personal credit or debit card with my own personal funds - not those of another person or entity - and that I meet the eligibility requirements set forth here: I am not a foreign national. I am not a federal contractor.

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Recurring Donation

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