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THANK YOU FOR YOUR DONATION

Your contribution will help us reach more voters and get our message out to the public. A contribution of 5$ $25, $50 or even $250 will help to canvass more voters, purchase additional yard signs, and distribute information.

You have my commitment that every dollar contributed will be spent informing voters of the opportunities that I can bring to the office. I appreciate your continued support.

HOW TO MAKE A CONTRIBUTION

Participating candidates may not accept contributions from an individual who is a communicator lobbyist, a member of the immediate family of a communicator lobbyist, or a principal of a municipal contractor or prospective municipal contractor.

Maximum contribution per state law is $250. However, if you are under the age of 18, the maximum contribution per state law is $30.

For mail-in contributions, checks should be made payable to Friends of Stephanie and mailed to 41 Yarwood Street, Stratford CT 06615. Please fill out this form, print it and mail it in with a check, do not submit this form online.

For phone-in contributions please call (203) 615-2880 to donate, do not use this form.

For online contributions please complete the forms. The Campaign requests that the contributor complete the entire certification form.

All fields are required!

First Name:

Last Name:

Email:

Address:

City:

State:

Zip-Code:

Telephone:
(ex. 203 555-5555)

Employer:

Occupation:

Check this box to confirm that the following
      statements are true and accurate:

  1. I hereby 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; payment on this card is not made from the funds of a corporation, labor organization or any other entity.

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

  3. I hereby certify that I am eighteen (18) years of age or older.

  4. I hereby certify that I or any business I am associated with does NOT have a contract with the Town of Stratford valued at more than $5,000.

  5. I hereby certify that I am NOT a lobbyist, or the spouse, or dependent child of a lobbyist.

  6. I further certify that all of the information set forth above on this form is true and accurate to the best of my knowledge and belief.