CAMPAIGN PLEDGE FORM

Dear Hopes Hands Board Members,

I/We would like to join you and other members of the community in your effort to meet the immediate and future needs of at risk teenagers in our community. To contribute to your mission I/we are making a pledge/gift to the Project Hope campaign as follows:

Please note my/our total pledge of $___________________________

I/We wish to pay this pledge over: _____ 5 Years _____3 Years _____ Other

Beginning:_______________(Date)

I/We wish to receive pledge payment reminders as follows:
[ ] Annual [ ] Semi-Annual [ ] Quarterly [ ] Monthly [ ] Other

If “other”, please explain: ___________________________________________________

_________________________________________________________________________

(Date):____________________________________________________________________

(Signature):________________________________________________________________

Name:_____________________________________________________________________

Address:___________________________________________________________________

City/State/Zip:_______________________________________________________________

Daytime Phone:_______________ Evening Phone:_____________________

Email Address:_______________


I/WE WISH TO BE LISTED ANONYMOUSLY…..................................................….. [ ] Yes [ ] No

I/WE ALLOW PUBLIC KNOWLEDGE OF OUR NAME AS A DONOR…................ [ ] Yes [ ] No

I/WE ALLOW PUBLIC KNOWLEDGE OF THE AMOUNT OF MY/OUR GIFT….. [ ] Yes [ ] No

I/WE WILL VOLUNTEER TO WORK ON THE CAMPAIGN….............................…. [ ] Yes [ ] No