Capital Campaign Pledge Intention

Capital Campaign Pledge Intention

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: __________________