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.


I confirm that the following statements are true and accurate: 1) This contribution is made knowingly and voluntarily from my own funds, not those of another, and the contribution is not controlled by another individual or made from the proceeds of a gift given to provide funds to be contributed. 2) This contribution is not made from the general treasury funds of a corporation, labor organization, or national bank. 3) I am not a foreign national who lacks permanent resident status in the U.S. 4) I affirm that this contribution is made either by personal check or on a personal credit card for which I have the legal obligation to pay, and not through a corporate or business-entity card or the card of another.