2024 Pledge Form

Annual Pledge Amount

Out of gratitude, for Fiscal Year 2024, I/We intend to give: $

Automated Withdrawal Plan

If you are able, we encourage you to elect to fulfill your pledge through an automated gift.

Please initiate a monthly ACH withdrawal that splits the above amount into 12 equal payments. I/We will provide a canceled check. (This option incurs no fees. Thank you!) Please continue my/our participation in the monthly ACH withdrawal plan with the above amount divided into 12 equal payments. I/We plan to give through Breeze and will update the associated Breeze account. (This option incurs transaction and/or processing fees.) Not at this time.

Personal Information

Name

This address will receive a confirmation email

Phone

Address

Description

If you have questions about pledging or completing this form, please contact Don Kusler, Financial Secretary, at financialsecretary@rockspringucc.org.

2024 Pledge Form

Description

Please Fix the Following