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We appreciate completion of all fields in the following form. If you are donating more than $100 to this campaign in this election cycle, by law,
you are required to provide all information designated with an asterick, i.e. name, home address, business address, employer and occupation.
Once you fill in the information and click "submit", you will be redirected to our PayPal Donation Page where you can make a secure online donation.
You may also download a PDF version of the form and mail it to us.
Thank you for your support!
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