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Greenfield Investment in Justice Challenge Grant Platinum Level $5000 plus Your gift will be doubled to $10,000 or more Gold Level $2500—$4,999.99 Your gift will be doubled to $5000--$9,999 Silver Level $1000—$2,499.99 “The Greenfield Challenge Grant to benefit the Your gift will be doubled to $2000--$4,999 Legal Aid Society of Palm Beach County is our way of ensuring that the disadvantaged residents Bronze Level of Palm Beach County will receive the equal access to justice and legal representation that $500—$999.99 every individual deserves.” Your gift will be doubled to $1000--$1,999 Richard and Peggy Greenfield in announcing the Greenfield Challenge Grant Other Your gift will be doubled Please fill out this form and mail to the Legal Aid Society of Palm Beach County 423 Fern Street, Suite 200, West Palm Beach, FL 33401. YES, I would like to help the Legal Aid Society of Palm Beach County, Inc., in fulfilling its mission of ensuring equal access to justice to all citizens of Palm Beach County by joining the Greenfield Investment in Justice Challenge Grant at the ____________ level with a pledge of $_____________ to be paid as a one-time gift or annually over 2, 3 or 4 years. ______________________________________________________________________________________ Contributor’s Name (will be listed in printed publicity) “ Check box if you wish to remain anonymous Payment Schedule: “ One-Time Gift “ Over Two Years “ Over Three Years “ Over Four Years “ Check enclosed Checks must be payable to “Legal Aid Society” “ Please bill the total contribution $__________to my credit card. “ VISA “ MasterCard “ Discover “ American Express ______________________________________________________________________________ ____________________________ Print name as it appears on card Expiration Date ____________________________________________________ _______________________________________________________ Card # Signature “ I will pay online at www.legalaidpbc.org CONTRIBUTIONS TO THE PRO BONO RECOGNITION EVENING BENEFIT THE LEGAL AID SOCIETY OF PALM BEACH COUNTY, A NOT FOR PROFIT, TAX EXEMPT ORGANIZATION. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION OF THE LEGAL AID SOCIETY (CH187) MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL FREE 1-800-435-7352 WITHIN THE STATE OF FLORIDA. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE. THE LEGAL AID SOCIETY RECEIVES 100% OF EACH CONTRIBUTION WITH 0% GIVEN TO A PROFESSIONAL SOLICITOR.
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