We want to be part of building HOPE, CONNECTION and COMMUNITYCampaign Pledge Form We are proud to make a total pledge of * $ Pledge Period * 1 Year 2 Years 3 Years 4 Years 5 Years Payment Frequency * One-Time Payment Monthly Quarterly Annually Other If you selected other, please add a note regarding payment frequency. Beginning Date MM DD YYYY Organization Name Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### I would like information about naming opportunities. Yes No I would like information about making my gift in honor of a loved one. Yes No The Virtue Center recognizes that every donor likes to receive project updates and routine communications differently. Please choose how you would prefer to receive communication from us (check all that apply). Mail Email Phone Please add your name as you would like for it to appear in donor honor rolls. * There are many ways to pay your pledge and support The Virtue Center’s Capital Campaign. Please indicate below which payment method works best for you. If you choose cash or check, then The Virtue Center will send quarterly pledge reminders. Payment Method * Check Cash Credit Card Electronic Funds Transfer Credit Card Information Please Charge my Mastercard Visa Amex Discover Name on Card First Name Last Name Billing Zip Code Account Number Expiration Date MM DD YYYY CCV Electronic Funds Transfer Information Checking Account Savings Account Name on Account First Name Last Name Name of Financial Institution Address Address 1 Address 2 City State/Province Zip/Postal Code Country Routing Number Account Number By signing and submitting this form, you authorize The Virtue Center to instruct your financial institution to debit your account as directed. This deduction will remain in effect until you chose to cancel giving 15 days written notice or by submitting an updated EFT authorization form if any information changes. Your gift will appear on your bank statement automatically. Each January you will receive a statement from The Virtue Center showing the amount you have donated through our EFT program during the calendar year (January-December). Save the statement for your documentation. Confirming your intent Your signature is confirmation that you have made this pledge to The Virtue Center to support the capital campaign. Your signature not only verifies your intent to pledge, but it also authorizes The Virtue Center to execute any payment instructions that you provided. You understand that your contribution will be used to underwrite costs associated with the capital campaign that may include capital, endowment, and operating expenses unless otherwise noted. This pledge agreement can be used as a collateral assignment to The Virtue Center and any assignee. * I agree I disagree Signature * Today's Date * MM DD YYYY Thank you for supporting the Building Hope, Connection and Community Capital Campaign. We will be in touch shortly. If you have questions, please contact Erin Williford at 405-321-0022 x 248 or email ewilliford@thevirtuecenter.org.
