Online Donation Form

Thank you for appreciating cancer does not just strike the Mom or Dad; it strikes their children as well.

For interested grant funders, planned giving or corporate partnership inquiries, please call Lindsey King, Director of Development at (404) 537-5255. 

If you have any issues making an online donation, please email JAJF to report your incident. Thank you for your support!

 

Please use the form below to make a safe and secure online donation to the Jack and Jill Late Stage Cancer Foundation.

First Name*
Last Name*
E-mail*
Confirm E-mail*
Address Line 1*
Address Line 2
City*
State,*Zip Code*
Phone Number
Format: xxx-xxx-xxxx
Please use this area to share a thought; to let us know you are making this donation in honor or, in memory of or on behalf of someone; or to give us any special instructions regarding the donation.
 
Donation Amount $*
Name on Card*
Credit Card*
MasterCard Visa American Express
Card Number (no dashes)*
Card Expiration Date (MM/YY)*
CCV Number*

Please only click the "Make A Donation" button once. Additional clicks will cause your donation to be submitted multiple times.

 
2006-2014 Jack & Jill Late Stage Cancer Foundation :: All Rights Reserved :: Terms of Use :: Privacy Statement :: Site Map
3282 Northside Parkway NW Suite 100 Atlanta, GA 30327 404.537.JAJF (5253) :: a 501(c)(3) tax exempt national public charity
Developed by Digital Positions :: Powered by boomsocket