Piryx™

Share This Page
Tweet 1

Stand with Rand

http://www.cuccinelli.com

Will you stand with Senator Rand Paul and support Ken Cuccinelli for Governor?

Chip in now to help Ken continue to defend liberty in Virginia.

Contribution Amount

$25
$50
$100
$250

$500
$1,000
$2,400
$

Personal Information

First NameRequired
Last NameRequired
EmailRequired
Home AddressRequired
Home Address (line 2)
CityRequired
StateRequired
Zip/PostalRequired
Phone NumberRequired

Employment Information

EmployerRequired
OccupationRequired

Payment Information

Debit/Credit Card

Card Number
CSC ?
Expiration

Routing Number
Account Number

Billing Information

Same as home address.
Billing Address
Billing Address (line 2)
City
State
Zip/Postal

Legal Compliance

I affirm that the following statements are true and accurate:

This contribution is made from my own funds and not those of another.

I am not a foreign national who lacks permanent resident status in the United States.

I want to publish my name to the Stand with Rand giving stream! (Note: your contribution amount will not be shown)

Your donation will appear on your credit card or bank statement as "RALLY/PIRYX"

Amount:

Your donation is being submitted. Please be patient.

By clicking submit you agree to our refund policy in our terms of service.

Contributions are not tax deductible for federal income tax purposes.

State law requires us to report the occupation and employer information for every person contributing more than $100 in the aggregate.

Checks should be made payable to “Ken Cuccinelli for Governor” Please mail to P.O. Box 6407, Springfield, VA 22150

Paid for and authorized by Ken Cuccinelli for Governor

This form is secured using 256-bit SSL encryption.

Piryx - The Social Giving Platform

Now fundraising is as easy as writing a blog or posting a status update and can be integrated into your website, product or mobile app. With Piryx, causes raise money online in more volume and much more effectively across the web. To learn more and create your own free account visit Piryx.com.