SUMMIT YMCA
Capital Campaign Pledge Form
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Email
*
example@example.com
Total Pledge Amount
*
Please enter the total annual amount of your pledge. If the 3-year pledge option is selected, this total will be divided by 3 (1x a year). Ex. $9,000 = $3,000 per year.
How would you like to make your gift?
*
I would like to make a one-time donation
I would like to make a 3-year pledge
Pledge installments are due annually on December 31.
Are you donating towards a furniture or purchasing package?
*
Yes
No
Please indicate the name or package number you are interested in donating towards:
Are you interested in a naming opportunity?
*
Yes
No
Please indicate the naming opportunity you are interested in:
How would you like your name listed for recognition?
*
Signature
*
Today's Date
*
/
Month
/
Day
Year
Submit
Should be Empty: