Make A Gift
Donation Form

Please accept my/our gift of $_________ to support the Barness Family JCC.

Name (please print) Employer

Address Employer Address

City State Zip

Home Phone E-mail Address CellPhone

Your Gift

My company has a matching gift program. I will initiate the process to increase my gift.

This is a:

• Personal Gift.
  Please list my/our names as ______________________________ in print material recognizing my/our gift.
• Anonymous gift.
• Tribute Gift.

  Please recognize this gift in honor/memory of:_______________________

  Honoree's address and phone: __________________________________

  __________________________________

  __________________________________

Form of Payment

• My check is enclosed and payable to the Barness Family JCC.
• Please charge my:
• Visa     MasterCard

Card Number Expiration Date

3 digit seucrity code Signature

All gifts are tax deductible as provided by the law.

Please mail or fax your contribution to: Barness Family JCC 908 N. Alma School Rd. Chandler, AZ 85224 FAX: (480) 517-0124

Questions? Call (480) 897-0588 Thank you for supporting the Barness Family JCC.