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EMPLOYMENT INFORMATION

If you are retired, please enter "retired" for both entries below. If you are not employed, please enter "none" for both.

CO-HOST LISTING

Please enter your name as you would like it appear on the co-host list. (Example: "Mary and Bob Smith")

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Select a Contribution Amount

(The amount below will be charged to your credit card every month on this day, ending before Election Day 2009. You will make a total of 6 payments.)

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CONFIRM YOUR ELIGIBILITY

Check this box to confirm the following is true:
  1. This contribution is made from my own funds, and not those of another.
  2. This contribution is made on a personal credit or debit card for which I have legal obligation to pay, and is made neither on a corporate or business entity card nor on the card of another.
  3. I am at least 18 years old.

Note: Only click this button once, otherwise your payment may be processed twice.