Westside Capital Campaign Pledge Form

Westside Capital Campaign Pledge Form
Contact Name*

First NameLast Name
Contact Phone Number*
Please enter a valid phone number.
Donating on behalf of...*

A company/corporationMyself
Name of Company/Corporation*
In support of the Westside Capital Campaign, I (we) pledge the sum of *
Balance to be paid as follows:*

AnnuallySemi-annuallyQuarterlyMonthlyOther
Annually over # of years* (default is December)
Every 6 months beginning Date*
Every 3 months beginning Date*
Beginning Date*
My (our) preferred method of payment is:*

Check payable to: Best Point Education & Behavioral HealthCredit card: Please contact the Office of AdvancementTransfer of corporate stocks, bonds, or mutual funds
*Note: Please do not use this form if you intend to request a transfer from a donor advised fund. Call the Office of Advancement for more information.
My (our) intention is that this gift be (check one):*

UnrestrictedRestricted (a specific designation within the capital campaign)
I would like to designate the funds in the order of the following priorities:*
For this pledge gift, I would like to...

Be acknowledged through an acknowledgement letter for tax purposesRemain anonymous
Please acknowledge and credit this gift in the following way:*
Name of Company/Corporation/Individual
Acknowledgement letter to be sent to: *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
*All gifts are tax-deductible to the extent allowed by law.
Should be Empty: