TO MAKE A DONATION TO THE CAMPAIGN!!! I want a free BEST bumper sticker I would like a lawn sign I would like to work on the campaign! Please contact me!
QUALIFYING CONTRIBUTION CERTIFICATION FORM FOR CANDIDATES PARTICIPATING IN THE CITIZENS' ELECTION PROGRAM
The Campaign requests that the contributor complete the entire certification form.
9. Principal Occupation _____________________________________________________
I understand that Connecticut law requires that a contribution be in my name and be from my own funds. I hereby affirm that this contribution is being made from my personal funds, is not being reimbursed in any manner,and is not being made as a loan. 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.
________________________________________ __________________________
Contributor's signature Date of contribution
I want a free BEST bumper sticker ??
I would like a lawn sign I would like to work on the campaign! Please contact me! For Campaign Use: Copy of check or money order (if applicable).
Print this form and forward to us
MAIL YOUR INFORMATION AND DONATION TO:
BEST FOR STRATFORD P.O. Box 663 Stratford, Connecticut 06615
Your contribution is greatly appreciated. Thank you!!!!!
