Lin Lavery for First Selectman :: Contribute

Contribute

I need your ideas, your energy and your contributions. Please donate whatever you are able to give, whether that is $25, $250 or $1000. Thank you for your support.

First Name: *

Last Name: *

Address: *

City: *

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Zip: *

Phone: *

Employer: *

(if not employed, write "none")

Occupation: *

Amount: *

$50 $100 $250 $1000 Other:

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Do you or your business have a contract with the municipality valued at more than $5000?

I am 18 years of age or older

I am either a United States citizen or a foreign national with permanent resident status in the United States.

This contribution is made on my personal credit card for which a legal obligation to pay and intend to pay from my own personal funds; payment on this card is not made from funds of a corporation, labor organization or any other entity.

If you would prefer to pay by check, please print out the following form and follow the instructions: Contribution Form (PDF)

Contributions or gifts to Lin Lavery for First Selectman are not tax deductible. We may accept contributions from an individual totaling up to $1000. Couples must send a jointly signed check from a joint account or a separate check of $1000 each to contribute a total of $2000.

This site approved by Lin Lavery.
Paid for by the Committee to Elect Lin Lavery First Selectman.
Brook Urban, Treasurer, 4 Little Cove Place, Old Greenwich, CT 06870