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Donation Amount

e.g. $17.76

Donation Frequency*

Donation Interval*

Name*

FirstLast

As stated in the Colorado Campaign and Political Finance Manual the name and address of the contributor must be reported for all contributions of $20 or more, and the contributor's employer and occupation must be listed for those $100 or more.

Email*

Phone*

Address*

Street AddressCityStateZip Code

The Federal Election Commission requires political committees to report the name, mailing address, and occupation and name of employer for each individual whose contributions aggregate in excess of $200 in a calendar year.

Employer*

Occupation*

The IRS requires us to print “contributions are not tax-deductible” on all fundraising appeals. Funds received in response to this solicitation are subject to federal contribution limits. Contributors from corporations and foreign nationals are prohibited

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