PLEDGE PAYMENT SCHEDULE
Return form and appropriate paperwork to Gift Processing Box #402
Purpose/Description:
Empl/Org ID #:
Donor Name/Company/Organization:
Contact name for Company/Organization:
Address:
Dual Empl/Org ID #:
Dual Credit Name:
Pledge Amount:		$
Fund/Org #:						and/or	Designation #:
Payment Schedule:
Date		Amount				Date		Amount
Credit Card type (circle one):				Visa	or	Mastercard
Credit Card #:						Exp. Date:
Anonymous:						Matching Gift:
In Memory / Honor of:
(circle one)
Acknowledgment to:
(name and address)
Sender Name:							Phone #:
School/Dept:
If you have questions please contact Donna Watson, Ext. 82873.