Friends of the BRTC

Funding must come from a PERSONAL account. Donations are NOT tax-deductible.

You must be over 18 years of age to use this form. State law requires the certifications shown.

The maximum contribution per individual is $2000 per calendar year.

Continue below for credit card donations. (Preferred)

To contribute by check, visit:

https://bethelrepublicans.com/bethel-rtc-form-p/

Choose Amount

Email*

Send me updates by email(not needed for receipts)

Phone*

Send me updates by text*

* By providing your phone number, you are consenting to receive text message updates, including automated text messages, to that number from Bethel Republican Town Committee. Message & Data rates may apply, and message frequency may vary over time. Reply "STOP" to opt out of these text message updates.

First name*

Last name*

Middle name

Title

Residential Address*

Apt, Unit, etc.

City*

State*

Zip*

This form only accepts US addresses.

Are you currently employed?*

YesNo

Employer Name*

Occupation*

Card Number*

Exp. Date*

CVC / CVV*

Zip*