Celebrate #GivingTuesday with DCCCA! We invite you to join and help celebrate DCCCA's mission during #GivingTuesday. Your generosity makes an enormous difference in the lives we serve. Thank you for considering DCCCA! Donation Information Amount $5 $10 $20 $50 $100 $250 $500 Type of Donation One Time Donation Recurring Donation Program/Department DCCCA DCCCA Pratt Elm Acres Recovery Services First Step at Lake View Family Preservation KC Family Preservation Wichita Fostering/Adopting Lawrence Outpatient Services Options Adult Services Other Recovery Today Traffic Safety Kansas Traffic Safety Missouri Traffic Safety Oklahoma Women's Recovery Center Other Donation Effort (please fill in if you chose "Other" for Program/Department): I would like to dedicate this donation Contact Information First Name Last Name Company Name Address Address 2 City State/Province Alabama Alaska Alberta Arizona Arkansas Armed Forces Americas Armed Forces Other Armed Forces Pacific British Columbia California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming Yukon Zip/Postal Code Home Phone Cell Phone Work Phone Email Credit Card Information Card Holder Name Card Account Number Expiration Date Month 01 02 03 04 05 06 07 08 09 10 11 12 Year 21 22 23 24 25 26 27 28 29 30 31 Security Code Billing Address Same As Above Address City State/Province Alabama Alaska Alberta Arizona Arkansas Armed Forces Americas Armed Forces Other Armed Forces Pacific British Columbia California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming Yukon Zip/Postal Code Email Next 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. ©2021 SofterWare, Inc. v.2021.01-A