What is the total monthly amount of your pledge? $___________ How do you wish to pay your gift? Weekly, monthly, quarterly, biannually, annually Do you want a receipt for tax purposes? YES NO What is Your Contact information? Name: Street: City, State, Zip, Phone E-mail How would you prefer to receive correspondence? E-mail, regular mail, phone, other Would you to like to receive our quarterly Newsletter? Yes No If yes how would you prefer to receive the Newsletter? e-mail, regular mail, on-line |