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

$5.00
$25.00
$50.00
$75.00
$100.00
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.