Jewel Charity - Benefiting Cook Children's

Jewel Charity 2012 Angel Donor Form

All donations made online are secure.


Donor Information

Name:
Please type the donor's name exactly as you wish it to appear in donor listings.
Address:
City:
State:
Zip:
Phone:
Email:

Donation Level Selections

If you would like to make monthly payments, please call the Jewel Charity office at (817) 732-9333, ext. 2

Please choose your donation level:

GABRIEL ARCHANGEL - ($500,000+)

RAPHAEL GOLDEN ARCHANGEL - ($100,000-$499,999)

RAPHAEL ARCHANGEL - ($50,000-$99,999)

ARCHANGEL - ($25,000-$49,999)

GUARDIAN ANGEL - ($10,000-$24,999)

GOLDEN ANGEL - ($5,000-$9,999)

SILVER ANGEL - ($3,000-$4,999)

ANGEL - ($2,000-$2,999)


MY DONATION AMOUNT
$.00

Do you wish to receive your complimentary page in The Jewel book ?
Yes, I do wish to receive my complimentary page
No, I choose to decline my complimentary page

Page Contact Information

Please fill out the following, if someone other than the donor is coordinating the page.

Name:
Phone:
Cell:
Email:

Are you ready to select your photo options?
Yes, I am ready to select my photo options
No, I am not ready at this time

Photo Options

Please select your photo option.

I Will Use an Official Photographer Photo

I Will Upload a Nonofficial Photographer Digital Photo

I Will Submit a Nonofficial Photographer Photo Print or CD to the JCD office

I Will Sponsor a Jewel Charity Provided Photo

Are you ready to type in the 5 lines of text for your photo caption?
Yes, I am ready to type in the text
No, I am not ready at this time

Photo Caption

Please type in the text exactly how you want it to appear as your photo caption. There are 5 lines and a maximum of 60 characters per line.
Line 1:
Line 2:
Line 3:
Line 4:
Line 5: