Contribution Rules

  1. 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.
  2. 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.
  3. I am at least eighteen years old.
  4. I am a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder).
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

Campaign finance law requires us to collect your occupation and employer.

{{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

If not employed please enter not employed. Complete even if you are self-employed.

{ binding firstError.message }

If not employed please enter name. If self-employed, please enter self.

Contribution Rules

  1. 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.
  2. 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.
  3. I am at least eighteen years old.
  4. I am a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder).
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Campaign finance law requires us to collect your occupation and employer.

{{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Occupation {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Employer {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Cognito Forms{{ Cognito.resources["powered-by-cognito"] }}