I am/We are: Member(s) Non-Member Gift Pledger(s)

Name(s):

Email:

Total Yearly Pledge Amount:

To be paid: Annually Quarterly Monthly Weekly  

Would you like us to include Your Name in a Giving Circle? Yes No

Is this amount 5% of your income? Yes No

Please send me an authorization form to complete and return so that I can pay my pledge monthly via: Electronic Fund Transfer (EFT) Credit Card