Amped Donation Pledge Form

Amped Donation Pledge Form

For any additional information, please contact: info@ampedlouisville.org
This agreement is entered in by Amped and:*

First NameLast Name
The Donor does irrevocably pledge to support Amped in a gift in the amount of:*
The gift I pledge will be fulfilled with the following schedule:
Donor Information:
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
The donor requests to be recognized as the following:
Signature*

Clear
Your gift is tax deductible as provided by law. An acknowledgement letter will follow the receipt of pledge payments made.
Should be Empty:

Donor Information: