Annual Donor Club Membership Form
Donor Club *
Payment Information
Are you making an individual, corporate, or political committee contribution? *
Form of Payment *
Please make your check out to "Republican Party of San Diego County"
While we will gladly accept credit card payments, but by choosing the check option, 3-5% more of your contribution will go towards helping elect Republicans in San Diego County.
How will we be receiving your check? *
Please mail your check to this address:
 
The Republican Party of San Diego County
Attn: Membership Director
PO Box 501278
San Diego, CA 92150-1278
 
(Please write "Donor Club" in the Memo field or include a print-out of your email confirmation.)
We will contact you shortly for pickup arrangements.
What type of card? *
Signature (use your touch screen, touch pad, or mouse in the space below) *
clear
Federal and State law REQUIRE we report the following...
All individual contributions must attest to statements 1 through 5. Please cancel this transaction now if any statement is not true. By selecting "Yes" below, I certify that: 
  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., nor do I personally contract with the federal government for personal services or the sale of goods, land or buildings. 
  4. I am at least 18 years old. 
  5. I affirm that this contribution is made 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.

Contributions to the Republican Party of San Diego County are not tax deductible. Federal and California law require political committees to report the name, mailing address, occupation and employer for each individual whose contributions aggregate to $100 or more per calendar year.

Do you attest to the above? *