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City of Seymour: JCUW Annual Campaign 2023

Online Giving

First Name *

Last Name *

Phone *

Email

Birth Date

Street Address

City

State

Postal Code

Leadership Giving

Booster $1,000

Merit $1,500

Pacesetter $3,000

Jackson Society $5,000

National Tocqueville Society $10,000+

Please choose the amount per pay period you would like to give to help the community!

I want to contribute the following amount per pay period *

$5
$10
$15
$25
$50
Fair Share (one hour's pay per month)
Same Donation Amount Last Year
Other

Pay Periods *

Weekly (52 payments)

Biweekly (26 payments)

Monthly (12 payments)

If you have selected fair share (one hours pay per month) please list your hourly pay.

Fair Share Amount

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Address

PO Box 94
113 N Chestnut, Ste 305
Seymour, IN 47274
812-522-5450

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