Have you made your campaign pledge yet? We need everyone's help. The construction cost of our projected National Research and Training Institute for the Blind is eighteen million dollars. Please take this opportunity to complete your pledge form. Without you our job will be just that much harder.

     The Campaign to Change What It Means to Be Blind

     Capital Campaign Pledge Intention

Name:_______________________________________

Home Address:_______________________________

City, State, and Zip:_______________________

Home Phone: Work Phone:_____________________

E-mail address:_____________________________

Employer:___________________________________

Work Address:_______________________________

City, State, Zip:___________________________

     To support the priorities of the Campaign, I (we) pledge the sum of $___________.

     My (our) pledge will be payable in installments of $ __________ over the next ____ years (we encourage pledges paid over five years), beginning _____________, on the following schedule (check one): __ annually, __ semi-annually, __ quarterly, __ monthly

     I (we) have enclosed a down payment of $ ________________

___ Gift of stock: _____________________ shares of _____________

___ My employer will match my gift.

     Please list (my) our names in all Campaign Reports and on the Campaign Wall of Honor in the appropriate Giving Circle as follows:

__ I (We) wish to remain anonymous.

Signed: ________________________________ Date: __________________