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Last Name: *

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Zip Code: *

Is this a new address?:

Yes

Home Phone: *

Email Address: *

Relationship to LJC: *

Is your spouse an LJC graduate?:

Yes

Your gift to LJC: $

Additional Gifts

Please note that the amounts listed below are in addition to your pledge above. If you wish to only give to the funds below, please enter "0" in the box above labeled "Your gift to LJC."

Diane Black Servant Leader Award Fund: $

Catherine Denney Memorial Scholarship Fund: $

General LJC Scholarships: $

Is this a payment on a current pledge?:

Yes

Comments:

Matching Information

Leadership Johnson County benefits from companies who match the gifts of their employees to double, or even triple their gifts, providing an even greater benefit to the College. You can increase the value of your gift to LJC if the company where you or your spouse work is a matching gift company. Some companies will match gifts of their retirees for several years following retirement.

Contact your company's human resources office to see if your company has a matching gift program or to obtain a matching gift form. Complete the employee section and mail the form to us. We'll do the rest!

Your Employer:

Your spouse's employer (if applicable):

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