Pledge Form for Organizational Donation Foundation for the Malcolm - PDF by selfesteem

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									                              Pledge Form for Organizational Donation
                    Foundation for the Malcolm Baldrige National Quality Award, Inc.

      To demonstrate our commitment to performance excellence in our Nation, we want to invest in the
                 Foundation for the Malcolm Baldrige National Quality Award, as shown:

Pledge Amount (Organizations with more than 1000 staff members and/or employees)

___________ Trustee ($150,000)                       ___________ Benefactor ($100,000-$149,999)
___________ Partner ($50,000-$99,999)                ___________ Sponsor ($25,000-$49,999)
___________ Other ($ _________)

Pledge Amount (Organizations with 1000 or fewer staff members and/or employees)

___________ Small Business Trustee ($25,000)

Instructions for payment: Your donation can be made in one lump sum payment or in three, and/or five
equal annual payments. Your organization will be invoiced to the contact person specified below:
PLEASE DO NOT SEND A DONATION WITH THIS FORM

Please note: A portion of your total donation may be appropriated for disbursement to State Award Programs
where you organization and units reside as a practice of Community Responsibility. The invoice sent will
provide further instructions on this disbursement policy. If you prefer that your entire donation remain with the
Foundation for support of the Baldrige National Program, please indicate by signing below:

________________________ I prefer that the entire donation support the Baldrige National Program

Please list our membership as:

Company:               _________________________________
Name:                  _________________________________
Title:                 _________________________________
Address:               _________________________________
                       _________________________________
Phone:                 ___________________

By:                    ___________________                     ____________________
                       (Signature)                             (Date)

Contact Name:          ____________________                    Phone: _________________

Billing Address:
      Name:            ________________________________
      Company:         ________________________________
      Address:         ________________________________
                       ________________________________
                       ________________________________

Please return form via mail or email to the address below – and do not send your donation at this time:
       Thomas Schamberger
       Executive Director, Foundation for Malcolm Baldrige National Quality Award, Inc.
       165 Summit Ridge
       Maryville, IL 62062
       Or email the form to ed@baldrigefoundation.org

								
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