JDonations - JEP Queens

* Donation Amount:

1 ticket for $36	2 tickets for $60
3 tickets for $75	5 tickets for $100
10 tickets for $180	15 tickets for $250
40 tickets for $500	100 tickets for $1,000
Donation of $10	Donation of $18
Donation of $26

* Charge my credit card:

One Lump Sum

In 2 monthly installments

In 3 monthly installments

Title:

* First Name

* Last Name

* Email Address

* Street Address

* City

* State/Province/Region

* Zip/Postal Code

Country

* Phone Number

* Name on Card:
* Credit Card Type:
* Credit Card Number:
* Expires:
* CVV: (4 digit code on front on AMEX cards or 3 digit code on back of others. Click here for more info.)

Comments

Referred By:

By clicking "Submit" I agree to allow JEP Queens to charge my card
as described above.

Please only click the Submit button once

Thank you for your donation! Your continued support will help us grow!
You will receive a confirmation email upon submitting and a receipt by email once the charge is processed.

* Indicates Response Required