General Fund

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 Newtown Democratic 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*

Residential Address*

Apt, Unit, etc.

City*

State*

Zip*

This form only accepts US addresses.

Are you currently employed?*

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Employer Name*

Occupation*

If you are self-employed, please list the name of your business as your employer (for example, Joanne's Printing Company)

Are you under 18?*

If you are under 18, contribution is limited to maximum $30

Are you a communicator lobbyist, or the spouse or dependent child of a communicator lobbyist?*

Do you, or a business with which you are associated, have a contract with the town of Newtown that is valued at more than $5,000?*

Are you a principal of a state contractor or prospective state contractor?*

Requirement*

I certify that I am NOT a principal of a state contractor or prospective state contractor. 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 I have provided my residential address. I certify that this contribution is being made from my personal debit or credit card for which I have legal obligation to pay and intend to pay from my own personal funds, is not being reimbursed in any manner, is not being made as a loan, and is not an otherwise prohibited contribution and that payment is not made from the funds of a corporation, labor union, or any other entity.

I certify and state that all of the information disclosed by me and set forth on this contributor form is true and accurate to the best of my knowledge and belief.

Click here for definition of terms.

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