Step 1: Select Payments
Step 2: Review and Submit
Step 3: Confirmation and Receipt
Step 1: Select Payments

Please complete the form below. When finished, click the Continue button and you will be asked to review the information for accuracy before your payment is processed.

*100% of all donated funds will directly benefit residents in need. Administrative and operational expenses for the Department of Human Services are covered by the Town of Westport’s operating budget and/or federal/state/local grants

The convenience fees for using this service are as follows: Electronic checks will be a flat rate of $0.95 per transaction. Credit/Debit cards incur fees of 2.95% of the total transaction with a $2.00 minimum. Multiple donations can be processed at one time.

Note: * indicates a required field.

My Bills
Payment Type: *
First Name: *
Last Name: *
Email: *
Phone: *
Home Address 1:
Home Address 2:
City:
State:
Zip:
Amount: *
Please select a fund to support: *
Seasonal program name if applicable:
My donation is:
Event (if applicable):
Please send acknowledgement of my donation to:
Honoree and Address or Email:
I would like to remain anonymous:

Cardholder Information
First Name: *
Last Name: *
Address Line 1: *
Address Line 2:
City: *
State: *
Zip Code: *
Phone Number: *
Email Address: *

Payment Information
Payment Method: *
Card Number: * 
Expiration Date: * (in mm/yy format)