Donate to Jay DiLisio for Attleboro City Council at Large

http://electj.com

11/05 is election day, and the team and I are gearing up for the journey to November and as 11/05 draws close I am looking to continue the progress we have started since 2012, and I am asking for your support to keep that progress going. We are at the starting point in the campaign where I need some assistance in order to purchase signs and literature. Recognizing times are tough across the board, I wanted to reach out to you and ask for your help and support to ensure victory on 11/05.

Contribution Amount

$11.08 - Helps pay for approximately 3 lawn signs
$22.16 - Helps pay for approximately 15 post cards
$33.24 - Helps pay for approximately 2 lawn sign and 8 post cards
$

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

Legal Compliance

I affirm that the following statements are true and accurate:

Please note that if you have already made a contribution to the campaign during 2011 to the maximum contribution of $500 per person/$1,000 per couple, we cannot accept another donation from you during this calendar year due to financial regulations. Also, no corporate checks, please.

I want to publish my name to the Donate to Jay DiLisio for Attleboro City Council at Large 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.

Paid for by the Committee to Elect James J. DiLisio

140 North Main Street Unit 10B

Attleboro, Ma 02703

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.

Piryx™