Online Donation

Please complete the entire form. We cannot accept contributions from an individual who is a principal of a state contractor or prospective state contractor or from a minor who is under 12 years of age. Under Public Act 2010-01, participating candidates may accept qualifying contributions from individuals who are communicator lobbyists or their immediate family members. Disclosure of lobbyist status remains a legal requirement pursuant to General Statutes § 9-608 (c) (1) (H).

Read Terms & Definitions.

To contribute by mail:pdfDownload this form

Donor information

Donation Information

Paypal (Paypal account NOT necessary. All major credit cards accepted.)
Communicator lobbyists may not make contributions to statewide or General Assembly candidates during the legislative session.

Donor Certification (confirm conditions 1 through 5)

I hereby certify that all of the information disclosed by me and set forth above on this contributor card is true and accurate to the best of my knowledge and belief.  
I certify that I am NOT a principal of a state contractor or prospective state contractor. See Definition of Terms above.  
I certify that I am either a United States citizen or a foreign national with permanent resident status in the United States.  
I certify that I have provided my residential address and that I am 18 years of age or older.  
I certify that this contribution is made on my personal credit card for which I have a legal obligation to pay and intend to pay from my own personal funds, is not being reimbursed in any manner, is not being made as a loan, is not an otherwise prohibited contribution, and that payment on this card is not made from the funds of a corporation, labor organization or any other entity.