Although there are many levels to assist our political activities, for a large majority, our party's get-

out-the-vote activities are fueled by small dollar donations coming from a wide spectrum of people
across Connecticut. Often, contributions of $10, $20, $50, and $100 make our Election Day efforts a
huge success.

We ask that you take a look at the CTGOP and our accomplishments. With a contribution to our
Party, you are making an investment in the future of our great state. I ask that you make the
commitment to ensure that our candidates are victorious.

Please mail your may your checks payable to Connecticut Republicans

Mail To
Connecticut Republicans
97 Elm St (Rear)
Hartford, CT 06106

Please PRINT this form and Mail with your check

Full Name:

*Employer:

*Occupation:

*Home Address:

*City: *State: *Zip:

*Phone:

*Email:

*Are You a Lobbyist?

Yes No

*Are You the Spouse of a Lobbyist?

Yes No

*Are You the Dependent of a Lobbyist?

Yes No

*Do you have a contract with the State of CT valued at more than $5,000?

Yes No

*Are you a director, officer, limited or general partner, or holder of 5% stock in a business which has
a contract with the State of Connecticut valued at more than $5,000?

Yes No