Thank You! Your Contribution Will Help Place this Initiative on the Ballot.

The Clean Elections Initiative will reduce the influence of special interest money in local San Diego campaigns by providing public funding for candidates who agree to "Run Clean".

Important!
In order for us to be able to process your donation, by law, we need your name, address, occupation or profession and employer. If you are self-employed, we need the name of your company and your position. If you are a homemaker or are retired, please indicate.

Step 1:
Please complete the necessary information on the form below and submit it to us.

NOTE: All fields preceded by a red asterisk are required!

*First Name:
*Last Name:
*Address 1:
Address 2:
*City:
*State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
*Zip:
Phone:
Email:

*Employment Status:

Employed If you have an employer please include your Occupation/Profession and Employer Name below. *Occupation/Profession: *Employer Name:

Self-employed If you are self-employed please include your Role or Position and Entity or Company below. *Role or Position: *Entity or Company:

Retired

Homemaker

Thank You!

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