Sample Contribution Pledge Form
ADVERTISEMENT
1Fundraising and Development
Sample Contribution Pledge Form
e C n
u o
g
rm
XYZ A
O
RT
RGANIZATION
PO Box 1234, Some City, Texas 79999
CONTRIBUTOR INFORMATION (Your personal information is kept confidential)
Last Name: ________________________________, First Name: _______________________________ MI: ____
Street Address: ___________________________________ City: ____________________ State ___ Zip _______
Telephone Numbers: Home (______)_____________________ Work: (______)__________________________
E-mail Address:_______________________________________________________________________________
I would prefer that this contribution and/or my name be kept confidential. Thanks!
DONATIONS
A O
-
D
,
A
:
NE
TIME
ONATION
IN THE
MOUNT OF
$5,000
$2,500
$1,000
$ 500
$100
$50
Other: $______________________
A R
D
,
:
EPEATING
ONATION
AS FOLLOWS
A sum of $ ______ Once Every
Month
Quarter
Year, amounting to a Total of $ ___________
M
C
ATCHING
ONTRIBUTIONS
Does your employer match donations?
YES / NO
Please enclose a signed Matching Donation Form from your employer if applicable
METHOD OF PAYMENT
Check enclosed, Please make checks payable to “XYZ Art Organization”
Please bill my credit card:
Card type:
Visa Mastercard American Express Discover
Account number:__________________________________
Expiration Date: ___________________________________
Securities or stocks. Please call 800/777-8989 or email to for details.
Contact me
NOTES
Contributions to the XYZ Art Organization are deemed charitable under section 501(a) of the internal revenue code as an
•
organization described in Section 501(c)(3). U.S. Federal Tax ID 761111111. Please consult your accountant for any clarifications.
Payments must be received before the end of the year to be eligible for a tax deduction in that year.
•
There is no minimum contribution amount.
•
1-800/777-8888
For more information please visit
or call
or write to
•
Please forward completed form and payment to:
XYZ Art Organization, PO Box 1234, Some City, Texas 79999
Or fax to 555/666-7777
Would you like to volunteer your time, resources, or ideas to XYZ Art Organization?
Yes!
TCA Tool-kit
43
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business