Piryx™

Share This Page
Tweet 0

AFCYR Holiday Party

http://www.afcyr.org

Your generous sponsorship helps us celebrate the successes of the past year, and ensures that AFCYRs can continue to promote Republican values in the Northern Virginia area.

Please help make sure that AFCYRs continue to spread the message of liberty in 2014. Become a sponsor of the AFCYR Holiday Party!

Personal Information

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

Referred By

Date of BirthRequired

Employment Information

EmployerRequired
OccupationRequired

Contribution Amount

$250 - Santa Claus sponsorship (lifetime membership included)
$100 - Rudolph sponsorship (membership included)
$75 - Frosty sponsorship (membership included)
$50 - Elf sponsorship (membership included)
$20 - Full membership (ticket to party must be an Arlington or Falls Church resident)
$10 - Affiliate membership (ticket to party)
$

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

I want to publish my name to the AFCYR Holiday Party 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.

This form is secured using 256-bit SSL encryption.

Payments by Piryx™

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.