Become a Patriot Partner | Act For America

To contact the donor department, please click here. Please note, we do not accept Discover Card.

Select an Amount

$ 20.00

$ 50.00

$ 100.00

$ 500.00

$ 1,000.00

Other Amount

Other Amount $

Total Amount

I want to contribute this amount every month

Your Registration Info

Email Address *

Phone (Primary) *

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Number & Street Name *

Suite /APT No.

City *

Country *

State/Province *

Postal Code *

Please click the contribute button once. Clicking more than once may result in multiple charges.