Progressive Crossroads Networking Fundraiser

1. Amount

$

2. Your information

Employer Info

Law requires we ask for your employer and occupation. If you don't have an employer or are retired, put N/A, and if you are self-employed put "self-employed" in employer and describe your occupation.

Contributions are not tax deductible.

3. Payment information

Contribution rules
By clicking on the "Donate" button you confirm that the following statements are true and accurate: 1. I am a United States citizen or a permanent resident alien. 2. This contribution is not made from the general treasury funds of a corporation, labor organization or national bank. 3. This contribution is not made from the treasury of an entity or person who is a federal contractor. 4. This contribution is not made from the treasury of an entity or person who is a contractor with the State of New Jersey or a County or Municipal government within the State of New Jersey. 5. This contribution is not made from the funds of a federally registered foreign agent. 6. I am not a minor under the age of 16. 7. The funds I am donating are not being provided to me by another person or entity for the purpose of making this contribution.
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