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Pledge Gift Form

Required

Tell Us About Your Gift

I would like to make a(n)...required
The amount you would like to give for EACH recurring charge.
The amount you would like to give for EACH recurring charge.
Other
The amount you would like to give for EACH recurring charge.
I would like to be charged on therequired
Please note that Ursuline will need to call you in order to collect credit card information for this recurring pledge. We will do our best to meet your requested Payment Date.
I would like to be charged on therequired
Please note that Ursuline will need to call you in order to collect credit card information for this recurring pledge. We will do our best to meet your requested Payment Date.
Other
What date would you like to be charged for the sum total of the amounts above?
Please note that Ursuline will need to call you in order to collect credit card information for this pledge. We will do our best to meet your requested Payment Date.

 

Gift OptionsPlease select up to 3 choices
Please select up to 3 choices
Your employer's HR department should be able to help you submit your matching gift form to UA.

 

Tell Us About You

Namerequired
First Name
Last Name
Countryrequired
Must contain only numbers
I am a(n)...Please select up to 6 choices
Please select up to 6 choices
Must contain only numbers
(if not applicable, put NA)

Payment Information

Please select a payment typerequired

Annual Giving Levels

giving levels

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Other Giving Options