Donation Form
The generous support of individuals, businesses and foundations helps CJR provide troubled youth with the resources and opportunities they need to achieve brighter futures.
If you are mailing your gift, please make checks payable to: CJR Fund, Inc.. Gifts are tax deductible as provided by law.
Please print and mail to:
CJR Fund of the Connecticut Junior Republic - CHK
Goshen Road, P.O. Box 161
Litchfield, CT 06759
 Yes, I / we want to help!
Here is my/our pledge of:
$1000 $500 $250
$100 $50 $25
$_____(other)
Please send me/us a contribution package so we can complete our pledge.
Enclosed is my/our gift of:
$1000 $500 $250
$100 $50 $25
$15 $_____(other)
Name
Address
City
State/Zip
Phone
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Optional:
This gift is: in memory of
in honor of:
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Please Notify
Relationship to person honored
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Address
City
State/Zip
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Does your company have a Matching Gift Program? Please check with your Personnel Office and enclose form with your contribution.
Other information:
I would like to know more about CJR. Please contact me.
I have included the Junior Republic in my will.
I am considering including the Connecticut Junior Republic in my will and would like more information.
I am interested in a CJR Fund Charitable Gift Annuity that pays income for life.
I would like the CJR kids to remember my birthday. (Please indicate date:__________).
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