YMCA Annual Campaign e-Pledge Form
Pledge/Gift Total Amount
*
Please enter the total amount you would like to pledge here. If you need this amount split into payments, that option will appear below.
Method of Giving
*
Bank Draft
Invoice Me
Credit Card
Bank Draft
Account on File
New account info
Invoice Me:
Monthly
Quarterly
Once in the month of
Credit Card
Card on file
New card information
I would like to make my payments
Once
Monthly
Quarterly
Last four digits of account/card on file
Payment Set-up Preference
Set up by phone
Set up via online link
Number of Months
Start Month
Month of
January
February
March
April
May
June
July
August
September
October
November
December
Payment Installment Amount:
Branch Designation
*
Association Office
Camp Classen
Chickasha Area
Downtown District
Earlywine Park
Edmond District
Guthrie
Healthy Living Center
Midwest City
North Side
Northwest District
Stillwater
Campaigner (if known)
Please list my/our names in donor recognition materials as:
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Other Notes
Signature
Clear
Submit
Should be Empty: