Donations
Credit Card Form
Thank you for considering the Janice
Mitchell Isbell Academy Inc. worthy to receive your donation. Please complete the information below. You will help educate a young person.
Please charge my credit card with my
Donation to the JANICE MITCHELL ISBELL ACADEMY, INC.
Please complete and return this form
to JMIA, P O BOX 17425,
Name____________________________________________________________________________________
Address__________________________________________________________________________________
City/State/Zip
Code________________________________________________________________________
Country__________________________________________________________________________________
Telephone
Numbers (H/C/W)_________________________________________________________________
Email____________________________________________________________________________________
Credit
Card Type (VISA/MC/AMEX/DC)________________________________________________________
Card
Number______________________________________________________________________________
Expiry
Date_______________________________________________________________________________
Security
Number
Amount
to be charged $____________________________________________________________________
Signature_________________________________________________________________________________
All donations are processed through PAYPAL’s secure site.
If there is a specific reason for donating, please indicate below:
_____In memory of _____________________________________________________________ .
To celebrate my ____ wedding anniversary; _____ birthday; _____ graduation from_____________ .
_____ Playground equipment. _____ Educational software. _____ Electronic equipment
_____ Please count me in as a monthly gift partner in the amount of $50.00 or ($_____) to be charged on the _____ day of the month.
_____ Other ___________________________________________________________________
