St. Joseph's Center Secure Online Donation Form
Sustaining Fund
Secure Online Donation Form


Please note that fields with an asterisk (*) are required.

*Please select your Donation Option: 

 Single Payment Donation

 I would like to divide my donation in five (5) monthly payments

 Recurring Monthly Donation


I would like to make a payment of $  for a total donation of $  .00 (Not applicable for Recurring Monthly Donations)

If you chose a monthly frequency, please select the date you would like us to charge your account:


*First Name:  *Last Name: 
*Address 1:  Address 2: 
*City:  *State: 
*ZIP Code:  *Email: 
*Daytime Phone #:  Evening Phone #: 

*Credit Card Type: 
*Credit Card #: 
*Exp. Date:  /

Is your employer a matching gift corporation?   Yes   No 
Employer information: (No commas or characters, please.)

 Yes, please tell me how I can further assist St. Joseph's Center through my estate plan/will.  


Special Requests: (No commas, please.)


After ensuring that all of the information above is correct,
please click the Submit Form Now button ONLY ONCE.
Multiple clicks of the Submit button will result in duplicate charges to your account.
An email confirmation will be sent to the email address you provided.


 

  
St. Joseph's Center
2010 Adams Avenue • Scranton, Pennsylvania 18509 • Phone: 570-342-8379 • Fax: 570-342-6080
Send us an e-mailwww.stjosephscenter.org


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