Donations Form Joshua Center for Neurological Disorders changing lives since 1996 Providing unparalleled service to kids with neurological disorders since 1996. Full Name* First Last Email* Enter Email Confirm Email Phone Number*Type of Donation/ Payment Joshua Center Programs and Services Donation ($500.00) Social Skills Monthly Scholarship Donation ($80.00) One Camper's Full Scholarship Donation ($750.00) One Camper's Partial Scholarship Donation ($250.00) Social Skills Class Payment ($40.00) Two Social Skills Class Payments ($80.00) Me and My World Card Deck (Normally $10.00) $5.00 Two Me and My World Card Decks (Normally $20.00) $10.00 Three Me and My World Card Decks (Normally $30.00) $15.00 Four Me and My World Card Decks (Normally $40.00) $20.00 Golf Open Payment 2026 Golf Open Team Registration ($480.00) 2026 Golf Open Individual Registration ($120.00) 2026 Golf Open Registration (Two Players) ($240.00) 2026 Golf Open Registration (Three Players) ($360.00) Golf Mulligans Enter Amount Based on Number of Mulligans: 1: $10.00 2: $20.00 3: $30.00 3 Mulligans per Player for Team of 4: $120.00 2 Mulligans per Player for Team of 4: $80.00 1 Mulligan per Player for Team of 4: $40.00Other Donation Amount Enter dollar amountTotal $0.00 Card Decks Ordered: Please list the topics you have chosen here. In Memory Of If making a donation in memory of someone, please let us know here. In Honor Of If making a donation to honor someone, please let us know here. Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Credit/Debit Card:* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Month010203040506070809101112 Expiration Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Expiration Date Security Code Cardholder Name Preferences I prefer to make my donation anonymously. Please sign me up for the newsletter. I already receive the newsletter. I wish to volunteer to help with the fundraising. CommentsCAPTCHAPhoneThis field is for validation purposes and should be left unchanged.