Emerge Wisconsin Application Fee

Congratulations on applying for the Emerge Wisconsin of 2023

The application fee is $35 - Your application is not complete until this fee is paid.

? Take future action with a single click.
Log in or Sign up for FastAction

Contribution Information

Amount

I'd like to help cover the transaction fees for my donation. My total amount will be $36.34.

Contact Information

First Name Last Name

Street Address Address Line 2 (Optional)

Postal Code City State/Province

Email Home Phone (Optional) Mobile Phone (Optional)

Yes, sign me up for email updates.

(Optional)

Employer Information

This information is required by law.

If you are self-employed, please list the name of the entity that is on your paycheck. Please list your line of work. "Business Person" is not acceptable, please enter the type of business instead.

Occupation Employer

I am retired

Payment Information

Card Number

Expiration Date

Remember me so that I can use FastAction next time.

Eligibility

I confirm that the following statements are true and accurate

By clicking on the "Contribute" button you confirm that the following statements are true and accurate:
I am not a foreign national who lacks permanent residence in the United States.
This contribution is made from my own funds, and not those of another.
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.
I am at least eighteen years old.
Contributions or gifts are not tax deductible.

Your donation will be securely processed.

Empowering Democratic women to run - and win!
www.emergewi.org