Multi-Year Gift to the NSYMCA for the Parking Lot
  1. Thank you for making a commitment to the Y with your gift to help help us renovate, resurface, add more handicapped spaces, and add new lighting - plus lose those potholes! It is because of community-minded donors like yourself that we are able to live out our mission each and every day.

    Please fill out the following form below to make your tax deductible gift to the Y.

  2. First Name(*)
    Please let us know your name.
  3. Last Name(*)
    Please let us know your name.
  4. Date(*)

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  5. Street Address(*)
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  6. Town(*)
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  7. State(*)
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  8. Zip Code(*)
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  9. Phone(*)
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  10. Your Email(*)
    Please let us know your email address.
  11. In honor of:
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  12. In memory of:
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  13. Please send an acknowledgement to:
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  14. Donation
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  16. Over how many years are you making this payment?
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  17. Payment to be made Per Year
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  18. Frequency of Payment Desired
    Choose One:


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  19. Payment Options below:
  20. Choose One:


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  21. Additional Opportunities:
  22. The Capital Champion Club is a $10,000 annual gift that can be renewed
    annually and includes membership and a reserved parking space for a year.


    Gold - payable over 1 year Silver payable over 2 years I am interested in being a member of the Capital Champions Club. Please contact me.
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  24. Would you like to choose a Naming or Dedication Opportunity in recognition for your gift?
    If so, we will contact you to discuss this. Click here to see the current list from the Capital Brochure.
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  26. Finalize My Gift:
  27. Print this page for your records. Be sure to click submit after printing.
  28. Payment
  29. Total
    0.00 USD