Aisin Drivetrain: JCUW Annual Campaign 2021-2022

Aisin Drivetrain:Online Giving

First Name *

Last Name *

Phone *

Email

Please include an email for a digital receipt.

Birth Date

Street Address

City

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Leadership Giving

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

Pay Periods *

Weekly (52 payments)

Biweekly (26 payments)

Monthly (12 payments)

Fair Share Amount

Other Amount

Please include any notes/comments you would like us to know about your gift.

Notes/Comments

Credit Card Information

If you would like to give a one time donation with a debit/credit card, please include the card number, expiration date, and code on the back. Please also include the dollar amount you would like charged in the "other amount" box above.

Electronic Signature

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