Capital Campaign Interest Form

"*" indicates required fields

Help JCCA pave the way to a 21st Century campus for our residents.

Note: All pavers purchased will be placed on JCCA's Pleasantville Cottage School at a later date. Purchasers will be notified once installation is complete.

JCCA operates one of the most respected residential treatment programs in the United States. Since it opened in 1912, thousands of children have called JCCA's Pleasantville Campus home—many of them living in the same cottages occupied by their turn-of-the-century forebears. It is time for an update. Your support allows us to provide a brighter future to the children we serve. With your help, we will repair the world, child by child.

Donation Type*

Pay by credit card

Pay by pledge (Payable over three years)

I'd like to:

Make a Donation

Reserve my Engraved Paver ($5000)

Donation Amount:*

Pledged Donation Amount:

Total Pledge with Paver Purchase and Additional Donation:

$0.00

Hidden

Pledge Discount

$0.00

Your Message

Note: All pavers purchased will be placed on JCCA's Pleasantville Cottage School at a later date. Purchasers will be notified once installation is complete.

Contact Later

I need some time to think about the text. Please contact me later.

Text for Paver Engraving:

Your Information

Corporate Checkbox

This is a corporate donation.

Anonymous

Please make this an anonymous donation.

Company Name*

Name*

First Last

Email*

Phone*

Payment Details

Credit Card*

Card Details

Cardholder Name

Address*

Street Address and Unit/Apt # City State / Province / Region ZIP / Postal Code

Covered Transaction Fee Checkbox

I'd like to cover all transaction fees so 100% of my donation goes to JCCA.

Subtotal to Calculate Transaction Fee

$0.00

Covered Transaction Fee

Price: $0.00

Total

Payment Type

Pledge Total (admin)

Amount (Admin)

Engraving (Admin)

Paver (Admin)

Donation (Admin)

Paver/Donation (Admin)

JCCA is a 501(c)(3) nonprofit organization. Donations to the Capital Campaign are tax deductible to the fullest extent allowed by law. To make a donation by mail, please send your check (payable to JCCA, with “Capital Campaign” indicated in the memo) to:

JCCA
Attn: Fund Development
858 E. 29th Street
Brooklyn NY 11210