GLOCK Certificate Entry Donation

https://www.bartowgop.com

Thank you for supporting the Bartow County Republican Party. You will receive one chance for every $50 Contribution. Once your donation is made, you will receive an email within 24 hours confirming your entries.

Contribution Amount

$50 - One Entry
$100 - Two Entries
$150 - Three Entries
$200 - Four Entries
$250 - Five Entries
$

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

Billing Information

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

I want to publish my name to the GLOCK Certificate Entry Donation 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:

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