Survey - Pledge to a CCB Brick Paver via Credit Card

Pledge to a CCB Brick Paver via Credit Card

Your pledge payments will be charged to your credit card on the 15th day of each month for 2 years. If you wish to fulfill your pledge sooner, please contact Liz Curnett at 513-636-4484 or liz.curnett@cchmc.org.

The 8 by 8 paver is $104.17 per month ($2,500 total).
The 4 by 8 paver is $41.67 per month ($1,000 total).

Question - Required - What size paver would you like to purchase?

8 by 8 paver

4 by 8 paver

Question - Required - Is this donation on behalf of a company?

Question - Required - I prefer to make this donation anonymously.

Billing Information


*	Title:
*	First Name: Required
*	Last Name: Required
*	Email: Required
*	Street 1: Required
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
*	Phone Number: Required
	Yes, I would like to receive postal mail from Cincinnati Children's

Question - Required - Cardholder's Name:

Question - Required - Credit Card Number: (example: 1234-1234-1234-1234)

Question - Required - Credit Card Type:

Question - Required - Card Expiration: (month/year)

Question - Required - Card Security Code:

Pledge to a CCB Brick Paver via Credit Card

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