Spring 2022 Donation Form

Campaign

I want to be a Jacksonville Community Center Champion, with a 3 year annual pledge starting in Spring 2024 in this amount:

I cannot make a multi-year pledge now, but I would like to make a gift in this amount:

Please enter a dollar amount

USDPlease enter a dollar amount

Full Name

First NameLast Name

E-mail

Phone Number

Area CodePhone Number

My gift is in the form of:

I authorize the Jacksonville Community Center to:

Other

If you have chosen to pay by check:

1. Please click "Print Form" below, and print this form.

2. Make your check payable to: Jacksonville Community Center

3. Mail the form and your check to: PO Box 1435 Jacksonville, OR 97530. Phone: 541-702-2585

You will be directed to PayPal in a few seconds after clicking "Submit", please complete all required information in PayPal.

Community is important to me!