Pledge Card
Date
*
/
Month
/
Day
Year
Date
Donor Title
Please Select
Dr.
Dr. and Mrs.
Mr.
Mrs.
Ms.
Mr. and Mrs.
Rabbi
Rabbi and Mrs.
Rabbi and Dr.
Mr. and Dr.
Drs.
Donor Full Name
Pledge Amount
*
Campaign/Fund
Pledge Schedule
Please Select
Due immediately
Due by a specific date
Due over a number of dates
Pledge Due Date
-
Month
-
Day
Year
Date
Pledge schedule details
*
Please include any information such as pledge schedule, length of commitment, etc.
Pledge Payment Method
Please Select
Send Bill
Sending Check
Credit Card or ACH
Other
Pledge notes
Please include payment method details, billing notes, dedications, etc.
Solicited by
Soliciter
First Name
Last Name
Signature
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