CCHS Online Donation Form

CCHS Online Donation Form

Make a donation to the Champaign County Historical Society to support the preservation, exhibition, and education efforts surrounding the stories of Champaign County, Ohio.
Condition Statement:

Thank you for your interest in the Champaign County Historical Society.

Payment can be made using any major credit card or debit card. Transactions are processed via Square and are encrypted for your protection.

Be sure that your browser (particularly Google) is up to date. An email will be sent to you immediately from noreply@jotform.com.

CCHS Refund Policy: Refunds for credit card purchases must be requested either via email or regular mail, and will be calculated as the (price of the item) less (associated credit card processing fees). The credit card charged will be credited with the refund amount. Credit card reimbursements will only be made directly to the credit card used for the original transaction.
Donor Name*

First NameLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Validator (Valid email is required for online donations)*
Phone Number
Please credit my donation to (donations without specification will be considered unrestricted):

UnrestrictedMemorialIn Honor ofEndowmentSplit it!Other
Can we publish your donation per CCHS publicity protocols?*

YesNo, please keep my donation anonymous.

Donations*

USDPlease enter your donation amount. Minimum donation amount is $10.00.