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PAC Donation FormDeidre Girard2021-06-07T08:11:17-07:00

PAC Donation FORM

Sign up for voluntary donations to the PROTEC17 Political Action Committee (PAC) by filling out this form authorizing payroll deduction.
  • I want to support the Political Action Committee!

  • I am least 18 years old.

    I am a U.S. citizen or lawfully permitted resident (i.e., green card holder)

    I am making these contributions from my own funds, and funds are not being provided by another person or entity for the purpose of making these contributions.

    I am not a foreign national nor are these contributions financed in any part by a foreign national, and no foreign national was involved in making decisions regarding these contributions in any way.

    I am not a federal contractor

    I am not a registered Federal lobbyist

    I am not a registered foreign agent.
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  • No employer or labor organization may discriminate against an officer or employee in the terms or conditions of employment for (a) the failure to contribute to, (b) the failure in any way to support or oppose, or (c) in any way supporting or opposing a candidate, ballot proposition, political party, or political committee you for contributing or not contributing to a political committee, or supporting or opposing a candidate, ballot measure or political party.

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