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To acknowledge the abilites of all children and for the betterment of our community, I/we pledge the following commitment to the
Kids Are Special Here Playground campaign:
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Total Amount of Gift: |
$ |
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Initial Payment: |
$ |
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Balance Due: |
$ |
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With the remainder to be paid as indicated:
First Payment Beginning: Month: Year:
This pledge will be competed in One year Two years Three years
I/We wish to fulfill the remainder of this commitment via:
(A
separate form will be provided for information necessary to your gift)
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Please
complete the following information: |
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Signature: |
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Date: |
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Organization: |
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Address/City/Zip |
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Make Checks payable to: Kids Are Special Here Playground – PCHHS Employee’s Foundation
Mail or Deliver to: Pineries Bank *3601 Main Street *
Gifts of any size are greatly
appreciated.