Donation

Donate

Thank you for supporting the Rutland County Democrats. To proceed with your donation please completely fill out and submit the form below. Upon completion of this form you will be transferred to PayPal to securely submit your payment. You may also contribute to the Rutland County Democratic Committee by sending a check to P.O. Box 933, Rutland, VT, 05702.

	* Means field is required
* First Name:
* Last Name:
* Address:
* City:
* State:	* Zip:
Home Phone:
* Amount:	$
* Employer:
	Self Employed (If self-employed, Check box AND enter "self" as your employer.)

* Occupation:
	* I confirm that the following are true and correct:
	* I am at least 18 years old. * I am a United States Citizen or a permanent resident alien. * This Contribution is not made from the general treasury funds of a corporation, labor organization. * The funds I am donating are not being provided to me by another person or entity for the purpose of making this contribution. Your donation will be used for local activities only. Your donation will not be used in Federal campaigns.
Comments:

	Contributions are not tax deductible.