llano

Monthly Donation Form

Please enter a monthly debit amount for sustainable funds for the Green Party of Texas. We are encouraging people to donate at least $10/month, which is equivalent to 30 cents a day to help establish a non-corporate sponsored, grassroots, political party.

We hope you agree it is worth the investment. Thank you for your support.

Instructions

Fill out the form below. Note that items in bold red are required. Once you select the "Proceed to Secure Server" button you will be directed to the secure server, where you may pay by either credit card or electronic funds transfer from a checking account..



Monthly Sustainer Information
Amount: $


Donor Information
First Name:
Last Name:
Address:
City:
State:
Zip:
Country:
Phone Number:
E-Mail Address:
Occupation (we are required by law to include this information):