ZOOM JUNE 4 CLUB MEETING VIDEO

http://qvgop.org/

Please submit this form and a donation of $5.00 or more in order to receive the link to view the video of the June 4th Zoom Club Meeting with Curtis Sliwa.

Thank you for your support for the work of America's oldest Republican Club. By submitting a donation, you agree to receive periodic email notices from the Queens Village Republican Club.

Note: after you've filled out the form, hit the "SUBMIT" button only once, and wait a few moments for it to finish processing.

Contribution Amount

$5 - Video Link
$

Personal Information

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

Payment Information

Debit/Credit Card

Billing Information

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

I want to publish my name to the ZOOM JUNE 4 CLUB MEETING VIDEO 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:

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

This form is secured using 256-bit SSL encryption.

Piryx - The Social Giving Platform