Senior Class Gift Pledge Form

Name:

Home   Phone:

E-mail:

Home      Address:

Yes, I want to make a $208 pledge!             I want to make an increased pledge!         
$208 Pledge = $28 in 2008 (payable now)        $500 Pledge = $ 50 in 2008 (payable now)
$40 in 2009                                                              $100 in 2009
$40 in 2010                                                              $100 in 2010
$50 in 2011                                                              $100 in 2011
$50 in 2012                                                              $150 in 2012

My gift is enclosed. (Please make checks payable to Stonehill College.)

Please charge my 2008 gift of $   (You will be billed for future pledge payments.)

American Express MasterCard VISA 

Credit Card #:

Expiration Date: __ __ / __ __ Signature: _______________________________________