Fillable Pledge Form (California State University, Chico)

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Pledge Form (California State University, Chico)

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Pledge Form
California State University, Chico
Today Decides Tomorrow
Name ______________________________________________________________________________________
Mailing address ______________________________________________________________________________
Street/PO City State Zip
Telephone ____________________________ ________________________________
Home Business
Fax ___________________________ E-mail ________________________________
Pledge Information
I (we) plan to make this contribution in the form of: □ cash □ check □ credit card* □ other ______________
To support the ___________________________________________________________________________________
I (we) wish to make a pledge of a total of $ _______________ to be paid: □ monthly □ quarterly □ annually
beginning on ______________________ending on _____________________ . Expected pledge payments _________
(Date) (Date)
*For your secure credit card gift, please log on to Make A Gift, http://www.csuchico.edu/url/gift
Acknowledgement Information
My (our) gift will be matched by _____________________________________________________ (company/foundation)
□ form is enclosed □ form will be forwarded
Please use the following name(s) in all acknowledgements: (Please print clearly)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
________________________________________ ____________________________________________
Signature Date Signature Date
Donor’s Confidentiality
CSU Chico is grateful for the support it receives from individuals, organizations, corporations, and foundations. One of the ways we may
express our thanks is through listing the names of donors in various publications. If you wish your name(s) to remain confidential and not
published or cited, please check the box and sign below.
_____ I (we) wish to have my (our) name(s) remain confidential and not published or cited.
For Advancement Use Only:
Account Name: ________________________________
Processed by: _______________ Date: _________
Account #: __________________
Rev. 09/14
Please make checks, corporate matches, or other gifts payable to:
University F
oundation
California State University, Chico
Chico, CA 95929-0155
(530) 898-4488
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Pledge Form (California State University, Chico)

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Completed 25 July 2020

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