INDIVIDUAL CONTRIBUTION FORM
Although there are many levels to assist our political activities, for a large majority, our party's
get-out-the-vote activities are fueled by small dollar donations coming from a wide spectrum of people across
Westport. Often, contributions of $10, $20, $50 and $100 make our Election Day efforts a huge success.
(The maximum annual total contribution is $1000 per indiviidual. However, the maximum is only $30 if under age 18.)

Please click the 'Donate' button to make a contribution via PayPal
(Please note: When making a PayPal contribution the form below must still be filled out completely and mailed)


or fill out the CT state-required certificate below, and use your browser to print it out.
You can then mail the form along with your contribution to:

Westport RTC
P.O. Box 601, Westport, CT 06881

Please make checks payable to Westport RTC


Name:
Home Address:
City: State: Zip:
Phone: Email:
Principal Occupation*:
Name of Employer*:

*Required if annual contributions exceed $100


Are you a lobbyist, or a spouse or dependent
child of a lobbyist?
Are you a principal of a CT state contractor or prospective state contractor?

If yes, which branch/branches of CT government
is the contract with? (Both if applicable)




Certifying Signature of Donor ____________________________________________________ Date_________________

 

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