Contribution Amount

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  $25
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  $50
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  $75
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  $100

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  $150
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  $200
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  $250
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  $

Legal Compliance

I affirm that the following statements are true and accurate:

By clicking this box, I hereby certify that all of the information disclosed by me and set forth above on this contributor card is true and accurate to the best of my knowledge and belief. I certify that I am either a United States citizen or a foreign national with permanent resident status in the United States. I certify that I am 18 years of age or older. I certify that this contribution is made on my personal credit card for which I have a legal obligation to pay and intend to pay from my own personal funds; payment on this card is not made from the funds of a corporation, labor organization or any other entity. I certify that I am not a lobbyist, lobbyist spouse, or lobbyist dependent.  I certify that neither myself, nor a business with which I am associated with have a contract with Fairfield which is valued at more than five thousand dollars.