Name (First) ________________________________________________
(Last) _____________________________________________________
Title ___________________________________________________
Company ___________________________________________________
Address ___________________________________________________
City ______________________________________________________
State __________________________
Zip Code _______________________
Telephone ______________________
Email Address ____________________________________________
How did you hear about JFYNetWorks?
What type of gift would you like to make? ________________________________
Check and Credit Card Donations
Please write the amount here
________________________________
Please find my check number ________________ enclosed
Please charge the above amount to my Mastercard or Visa (circle one)
Credit Card Number ________________________________
Expiration Date ________________________________
Name on Credit Card ________________________________
Signature ________________________________
Thank you very much for helping us fund our mission.
Once we have reviewed this information, we will contact you about the next step.
If you are making a donation by check or credit card, we will mail you a letter for your files that can be used in preparing your taxes.
