AOA Pledge Form

AOA Pledge Form
Name as you want to be recognized
Included spouse/partner if joint gift
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Pledge Payment Options

Other Amount -minimum Pledge amount is $2,500
I will pay over the course of

Other - donation is over $50,000
Please direct my gift to the following AOA signature program(s). If you do not have a program preference, please select Unrestricted Support/Mission Critical Education of the AOA.
If you selected more than one fund above, please indicate how you want your funds allocated
e.g. $5,000 to Own the Bone and $5,000 to Emerging Leaders
In addition to selecting a program(s) above, if your gift is made in tribute, please complete the following:
Select a Pillar Tribute
Tribute Name
Are you over the age of 50 and making a donation/pledge over $50,000?
I will pay this donation over the course of
Are you age 50 or younger and making a donation/pledge of $50,000 or more?
I will pay this donation over the course of
Payment Method
Note: If you want to make a donation using your credit card, please click this link. If you want to make a pledge payment via credit card, please click this link.
The American Orthopaedic Association (AOA) is a not‐for‐profit 501(c)(3) organization, operated and existing under the laws of the state of Illinois. The AOA does not provide legal or financial advice to donors; please consult with your own financial attorney/advisor to determine a donation structure appropriate for your personal circumstances and whether your donation qualifies for a tax deduction under federal law.
- Signature Required to Complete Your Pledge
  
  I sign this pledge with the intent to be legally bound. If I should die prior to the time this pledge is paid, I direct that my personal representative satisfy this pledge as a debt of my estate.
- Date
  
  MonthDayYear
  Date
  Hour MinutesAM/PM Option
- Should be Empty: