Contribute

 OPTIONAL INFORMATION (if you select any of these optional selections, be sure to submit your contact information using the form below):
I will volunteer my time to help Darab get elected in November 2005.
I will put a sign for Darab in my yard or in my business.
I will host a coffee at my house so my neighbors can meet Darab.
You may add my name to Darab's public list of endorsements.

REQUIRED INFORMATION FOR ALL DONORS:

 I confirm that the following statements are true and accurate:
  • I am at least 18 years old (or will be by Nov 8, 2005)
  • I am either a citizen or a permanent resident of the United States
  • This contribution is made from my own funds, and not those of another
  • This contribution is not made from the funds of a corporation or labor organization
  • This contribution is made on a personal credit card or debit card for which I have the legal obligation to pay, and is not made either on a corporate or business entity card or on the card of another person

    • California law requires that all donors provide the following information (* denotes required fields):

    First Name*:
    Last Name*:
    Occupation*:
    Employer*:
    Address*:
    City*:
    State*:
    Zip*:
    Phone*:
    Fax:
    Email:
       
     

     

     

    Political contributions are not deductible for income tax purposes. 

    		  

    1519 Meadowlark Lane, Sunnyvale, CA 94087
    Tel: 408-718-9142 | ID#: 1278310 | Email: darab@ghaffary.com