NBWDC Donation Form
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Contribution Rules
The Federal Elections Commission requires that we collect the following information from all NBWDC donors to avoid penalties and fines.  Your cooperation in helping us comply with these Federal rules is greatly appreciated, as are your donations and support.

Contribution Rules
1. I am a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder).
2. I am at least eighteen years old.
3. I am not a federal contractor.
4. This contribution is subject to the limitations and prohibitions of the Federal Election Campaign Act.
5. This contribution is made from my own funds, and funds are not being provided to me by another person or entity for the purpose of making this contribution.
6. I understand that donations and payments made to NBWDC, a political-party organization, are not allowed as tax-deductible charitable contributions.

By submitting this form you confirm that you have read and conform to the rules noted above.
First Name *
Last Name *
Email Address *
Email Permission *
May we add you to our Email Newsletter list?
Primary Phone #
Please include Area Code (eg:  111-111-1111)
Primary Phone Type
Clear selection
Permission to Text
May we text you with event news and updates?
Clear selection
Political Party Affiliation *
Select the party affiliation that matches your Voter Registration record
Who referred you/how did you find us?
Let us know if there is someone we can thank for your referral. Include their name in OTHER below.
Clear selection
The Federal Elections Commission requires NBWDC to maintain the following information for all our donors.
Donation Purpose *
Required
Donation Type *
Check all that apply:
Required
Amount or Value of Donation(s) *
Total dollar value of this donation (eg: 55.00, 583.23, etc.)
Donation Description *
 If money, include check# or type of credit card; if in-kind item or service then description (eg Postage, supplies, gift cards, etc.
Occupation *
Enter Occupation or "Not Employed"  
Employer/Business Name *
(If employed, enter Employer Name,  If self-employed enter Business Name; if "Not Employed" enter NONE)
Address Information
Current Street Address *
Street #, Street Name, Unit # if applicable
Current Zip Code *
Is the above address the same as your . . . *
Yes
No
Voter Registration Address
Mailing Address
Comments or questions?
By submitting this form you confirm that you have read and conform to the rules noted above.  Thank you for your donation and support of NBWDC!
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