Please fill out the form below if you would like to donate to the New Canaan Republican Town Committee.

How much would you like to donate to the New Canaan Republican Committee? *
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Do you have a contract with the state of Connecticut valued at $5,000 or more? *
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Are you an officer, director, limited partner, or general partner of a firm with a contract with the state of Connecticut valued at $5,000 or more? *
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Do you certify that you are a U.S citizen or a foreign national with permanent resident status in the United States; and that this contribution is made with personal funds and is not being reimbursed in any manner; and that all of the information disclosed by you on this contribution form is true and accurate to the best of your knowledge? *
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