Support your local Coventry Democrats!  Make a difference!


(See Definitions and Notes below)
Use Your DonorID (optional)
Your card code is incomplete. Your card code is invalid. Your card code is missing. Your expiration date is incomplete. Your expiration date is missing. Your expiration date is in the past. Your card number is incomplete. Your card number is invalid. Your card number is missing. Your billing ZIP is incomplete. Your billing ZIP is missing.

Complete your donation below using PayPal.

I hereby certify and state 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 either a United States citizen or a foreign national with permanent resident status in the United States. I certify that this contribution is being made from my personal funds, is not being reimbursed in any manner, is not being made as a loan, and is not an otherwise prohibited contribution.

By accessing this form you agree to the
Terms of Service and Privacy Policy.

Definitions

Click here for definitions of items on this form.


Notes:

●  Required Field

Employer - If multiple employers and one is a state contractor, list the state contractor. If self-employed, provide Name of Business. Example: Dave’s Painting; Other Examples: Retired, Unemployed, Student, Homemaker

Principal Occupation - If self-employed, provide Job Description. Example: Painter; Other Examples: Retired, Unemployed, Student, Homemaker

Are you a communicator lobbyist? - Note that under Public Act 10-1, communicator lobbyists and their immediate family members are permitted to give contributions of up to one hundred dollars in the aggregate to party committees.

Close

Sign in to save time donating

PAID FOR BY COVENTRY DEMOCRATIC TOWN COMMITTEE


Support ©Anedot

Anedot

Donations Secured by Anedot

Anedot protects your financial data:

  • All forms use TLS encryption to transmit your information.
  • Your financial data is used to process transactions and is not shared with additional third parties.
  • All transactions are processed adhering to Payment Card Industry (PCI) Level 1 compliance.
  • If you opt to save your payment data for future transactions, your data is stored in a PCI Level 1 compliant facility.

Learn More about how Anedot's tools help causes and campaigns easily collect payments and donations.