FISHBEIN for COUNCIL
100 SO. MAIN STREET, WALLINGFORD, CT 06492
Just a few reminders when making your donation:
1) We cannot accept any donation in excess of $250.00.
2)
PLEASE use a personal check to make your contribution.
(By law, we cannot accept business checks).
3)
The one who signs the check is the contributor. (So if
more than one member of
your household wants to
contribute, they must send separate checks)
PLEASE INDICATE:
4) Is the contributor a lobbyist, or spouse, and/or dependent child of a lobbyist?
Please Circle: YES or NO
5) Does the contributor or business he/she is associated with have a contract with the Town of Wallingford valued for more than $5,000.00?
Please Circle: YES or NO
Name:
Address:
Telephone:
Employer:
Occupation:
o
Please contact me
about putting a lawn sign on
my property.
THOMAS VITALI, Treasurer
Approved by Craig C. Fishbein
THANK YOU FOR YOUR SUPPORT!