Capital Campaign Pledge Form
Please fill out the form below to make a pledge for our Museum Revitalization project.
Full Name
*
First Name
Last Name
Company Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
example@example.com
Phone Number
*
Please enter a valid phone number.
I am pledging to support this campaign with a total donation of:
*
$1,000.00
$15,000.00
$2,500.00
$20,000.00
$5,000.00
$25,000.00
$10,000.00
Other
Frequency of Payment:
One-time
Monthly
Quarterly
Yearly
For a Time Period of:
Payment Method
Please Select
Credit Card
Check
Cash
Preferred Contact Method
*
Email
Phone
Mail
Additional Comments
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Should be Empty: