EmailMe Form - Republican Party of Virginia Beach

Republican Party of Virginia Beach
State and Federal law requires us to gather the following information from online donors.

* Individual and corporate contributions are allowed, and are deposited in a non-Federal account.
* Contributions are not tax-deductible.
* All contributions totaling more than $100 within a calendar year from a single person or source must be disclosed in financial disclosure reports, including the contributor's name, occupation and location of employer.

Name *

First

Last

Address *

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Phone Number *

###

####

Email *

Occupation *

Employer *

Please designate the donation you wish to make or the event you wish to attend: *

Elephants & Executives
$35.00 & 50.00

120 Club
$120.00 per year

City Committee
$50.00 per year

General Donation

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