The law requires us to use our best efforts to collect and report the name, mailing address, occupation, and employer of individuals who contribute. By law, we must obtain the full street address of all donors.

Name *

First 		 

Last
Address

Street Address

City


Zip Code

Email


Phone *


Occupation *


Employer *
State
Donation *

$10.00 Contributions are not tax deductible for income tax purposes.
$25.00 The maximum contribution an individual or company may give is $500. Personal checks are acceptable.
$50.00 A couple may give $1,000 from a joint account if both parties sign the check.
$100.00
$250.00 Federal law prohibits contributions from foreign nations.
$500.00 An immigrant is eligible to make a contribution if he or she has a "green card" indicating that
OTHER he or she has been lawfully admitted for permanent residence in the United States.


Legal Compliance *

Check this box to confirm that the following statements are true and accurate:
  1. I am a United States citizen or permanent resident alien.
  2. This contribution is not made from the funds of an individual registered as a lobbyist with the City of Los Angeles, or from the funds of a lobbying firm.
  3. This contribution is from my own personal funds and will not be reimbursed by any other person.