Donor Form

Yes, I want to do my part to support the CTA.

Please print this form and send it with your contribution to:

Clinton Taxpayers Association
24 West Main Street, Suite 390
Clinton, CT 06413


First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Please indicate amount
of contribution or other
comments here:

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