On-line Contribution Form:
                                            * denotes required field
   Email address: *
         First name:.*
         Last name:.*
   Street address:.*
                    City:.*
  State/Province: .*
             Country:.*
 Zip/Postal Code:.*
 
                                              I am self-employed.
          Employer:
       Occupation:
                       
 
                         Check each box that applies to you:
      I am a United States citizen or a permanent resident alien.
 
      This contribution is not made from the general treasury funds of
            a corporation, labor organization, or national bank.
 
      This contribution is not made from the treasury of a person or
            entity that is a federal contractor.
 
      The funds I am donating are not being provided to me by another
            person or entity for the purpose of making this contribution.
 
      I am at least 18 years old, or the funds I am donating are my own
            personal funds and I am donating these funds knowingly and voluntarily.

Comments:

 

Contribute
   On-line
On-line credit card contributions made to Democrats Abroad Argentina are
secure, encrypted transactions made via PayPal.
.
However, if you prefer to pay by check, please note the requirements below and send your contribution to:
.
Democrats Abroad Argentina
Esmeralda 1385 7º D
Buenos Aires C1007ABS
Capital Federal
República Argentina
.
For more information contact us at contact@democratsabroad.com.ar or by telephone at:
(011-5411) 4322 -0968 in Argentina
or
312 224 8490 from the United States