If you are choosing a recurring donation option, please make sure that the Total Gift Amount is the total amount (sum of each recurring donation) that you wish to contribute this year.  

* required information
Donation
Select Gift Frequency
I would like to make a one-time gift for the following amount:
:* $
I would like to make a recurring gift.
Gift Amount* # of Payments Payment Frequency Total Gift Amount
$ X = $
NOTE: Each payment, including the first payment, will be made on day 15 of the month based on the payment frequency you have indicated.
Donor Designations
Select a designation for your contribution*
 
Donor Information
First Name:
Last Name:*
Email:*
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
Phone:
Do you have youth in the Council's programs?: Yes
No
Name of youth in the program?:
District?:
Unit Type?:
Unit Number?:
Payment Information
Payment Method
:*
:*
:*   Explain
Credit Card Type:*
                  
Credit Card Expiration:*
Billing Information
If the billing information is the same as the contact information check this box.
If not please fill out the information below:
:*
:
:*
State:
:
:*
Country:*
Matching Gift Information
Please click here to to search for your company.
Will this donation be potentially matched?
If you know the following information regarding the matching gift, please complete.
Company Name:
Matching Gift Amount:$
Additional Information
This is a payment to an existing contribution?:* Yes
No
Prospect ID Number from billing statement:
Special Note or Instructions:
By clicking Submit,
your credit card will be processed