Donation Form

Thank you for your support of Jericho Road Ministries! When you give,
you help provide meals, shelter, and other essential care,
while also sharing the hope of the Gospel.

This form is for making a one-time donation to our ministry.
If you would like to join the Green Circle, Jericho's community
of monthly givers, and have your gift automatically applied each month,
please click here:

Donation Information

Amount

I would like to dedicate this donation

Contact Information

First Name

Last Name

Company Name

Address

Address 2

City

State/Province

Zip/Postal Code

Home Phone

Cell Phone

Work Phone

How did you first hear about Jericho?

Help Us Cover Costs

Simply leave "Yes!" checked below to ensure that 100% of your intended donation is available for our mission.

Yes! I want $0.00 to go to Jericho Road Ministries Inc. and I will donate $0.00.No. I will donate $0.00 and Jericho Road Ministries Inc. will cover the processing costs.

Payment Information

Payment Options

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

Security Code

Billing Address

Same As Above

Address

City

State/Province

Zip/Postal Code

Privacy Policy
We take precautions to protect your information. We collect credit card or bank account information, names, addresses, and other data related to your transaction when you make a payment through our site. We use this information to process your payment.

Terms/Conditions
By submitting your payment, you authorize us to charge the account above for the amount specified in the Transaction Amount field. Account information for Recurring Pledges/Monthly Giving is encrypted and stored securely via SafeSave™ for automatic processing of your future payments. Notify us at anytime if you wish to discontinue your pledge.