Donation Amount
*
Frequency
*
Please Select
One Time
Monthly
Quarterly
Designation
Please Select
General Purpose
Capital / Building
Please Direct My Gift to the Following Arts Place Location
Auglaize/Mercer Center
Blackford County Arts Center
Jay County Campus of Arts Place
Comments
Contact Information
Salutation
Please Select
Mr.
Ms.
Mrs.
Dr.
First Name
*
Last Name
*
Phone
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Acknowledgement
Please list your name(s) as you would like it to appear in our programs.
Please Make my Donation Anonymous
Please verify that you are human
*
My Products
prev
next
( X )
USD
Payment Methods
Debit or Credit Card
Please click one of the PayPal options to complete payment and
submit
the form.
Make Donation
Should be Empty: