Marshfield Area YMCA - Build People Campaign Pledge Form

Printable Pledge Form
Please complete and return to the Marshfield Area YMCA

	____ Mr. ____ Mrs. ____ Ms.
Name	_____________________________________________________
Address	_____________________________________________________ _____________________________________________________ _____________________________________________________
Phone	(_______) ________________________
Email	_____________________________________________________

	I want to make a pledge of:
	______ $ 1000 ______ $ 500 ______ $ 250 ______ $ 100		______ $ 50 ______ $ 25 ______ $ 10 Other: $ ________

	_____ Banner Sponsor _____ Gymnasium Banner ($1,000) _____ Pool Area Banner ($1,000) Banner to read: _____________________________________________

	I would like to make pledge by:
	____ Credit Card:
		_____ Visa	_____ Mastercard
	Acct #: ___________________________________
	Exp Date: _______/________
	Signed:____________________________________

	____ Enclosed Payment Enclosed is my check payable to the Marshfield Area YMCA
	____ Other _______________________________ (Please note billing preference)
	Signature _________________________________

Marshfield Area YMCA Attn: Finance Director 410 W. McMillan Street Marshfield, WI 54449