Vote Hazelo - Online Contributions by eFundraising Connections

1 Contribution Have an eFundID? Login

$2,400.00
$1,200.00
$600.00
$250.00
$100.00
$50.00
$ Other

Please select a contribution amount

Please select an even decimal contribution amount if giving as a couple.

Iterations

This recurring donation will process every Sunday.

This recurring donation will process on the 7th of every month.

2 Personal Information

Phone

First Contributor

First Name

Last Name

Company Name

I agree to the following statements:

Certification that Contribution is Not From a Foreign National
I certify that the entity making this contribution is not organized under the laws of, and does not have its principle place of business in, a foreign country. This contribution is not financed in any party by a foreign national, and foreign nationals were not involved in making decisions regarding the contribution in any way.

I, the Authorized Agent listed above, certify that the entity is making this contribution. This contribution is being made, and this certification is being submitted, as of today.

PAC Name

PAC ID

Second Contributor

First Name

Last Name

Joint Address

Address

City

State

Zip

First Contributor

I am retired

Employer

Occupation

The Public Disclosure Commission requires all donation over $250 to provide

occupation, employer, city, state and zip code

Second Contributor

I am retired

Employer

Occupation

The Public Disclosure Commission requires all donation over $250 to provide

occupation, employer, city, state and zip code

3 Payment Method

Credit Card Number

MM/YY

Security

CVC on Visa/MasterCard/Discover is a 3 digit code on the back of the card. CVC on AMEX is a 4 digit code on the front of the card.

My credit card address is different than my home address.

CC Zip

Please select a contribution amount

Comment

I agree to the following statements:

Campaign Donations are not tax deductible.

Total donation amount may not exceed $2400.00

Please click the reCAPTCHA checkbox

Only use the above payment option(s) for individual contributions. Contribute by credit card for corporate or couple donations

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Unable to process with ACH. Please check your routing/account number or choose another payment method

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Please select an option.

Please input a value between $10.00 and $2400.00

Iterations may not exceed 32000

Total recurring amount plus merchandise may not exceed $2400.00. Please reduce the number of iterations, or reduce the payment amount.

Time span must not be past credit card's expiration date

Please select this before proceeding

Iterations must be a number greater than 0

Total donation amount may not exceed $2400.00. Please reduce the number of iterations, or reduce the payment amount.

Credit Card number must have 15 digits

Credit Card number must have 16 digits

Credit Card number is not valid

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Number of Weeks

Number of Months

Number of Quarters

Number of Years

PayPal accepted

Please click the PayPal button, or choose another payment method

PayPal failed. Please try again, or choose another payment method

Venmo failed. Please try again, or choose another payment method

Apple Pay accepted

Please click the Apple Pay button, or choose another payment method

Apple Pay failed. Please try again, or choose another payment method

Please select a contribution amount

All fields are required

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