Victory Club: Checkout One-Time

Level *

$ 120.00 Staffer

$ 300.00 Councilor

$ 600.00 Mayor

$ 1,200.00 Governor

$ 3,000.00 Representative

$ 6,000.00 Senator

$ 12,000.00 President

Email Address *

Name and Address

First Name *

Last Name *

Street Address (Home)

City (Home)

Postal Code (Home)

Country (Home)

State (Home)

Credit Card Information

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Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

FEC Requirements

Legal Compliance

Federal law requires that we use our best efforts to collect and report the name, mailing address, occupation and employer of individuals whose contributions exceed $200 in a calendar year.

If you are retired, please enter "Retired" for both Employer and Occupation entries above. If you are not employed, please enter "None" for both fields. If you are self-employed please enter "Self" for Employer.

Contributions are not deductible as charitable contributions for federal income tax purposes. Funds received in response to this solicitation are subject to federal contribution limits.

By clicking the Order button below, I certify that the following statements are true and accurate:

This contribution is made from my own funds with a personal credit card, and not with a corporate credit card or funds provided to me by another person. I am not a federal government contractor, nor am I a foreign national who lacks permanent resident status in the United States. I am at least 18 years old.

Employer *

Occupation *