Pledge Form

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					                                          Pledge Form
                   (Please complete all requested information and print clearly)
        In consideration of the gifts and pledges of others to help ensure the future of the
                  American Guild of English Handbell Ringers (AGEHR),
                 I/we promise to give AGEHR, a recognized 501(c)(3) charity,
       a tax-deductible gift in the amount of $                   , payable as noted below.

A. Pledge Schedule
   To be paid within 3 years:  Monthly  Quarterly  Semi-Annually  Annually
    Other ______________            Anticipated amount of each gift payment $ _________________

B. Initial Pledge Payment
   Please accept my initial gift payment of $_______________ enclosed by
    Check #______________ Please make check payable to “AGEHR”
    Credit Card: MasterCard or Visa (please circle choice)
      Account Number
      Security Code                          Expiration              /
      Card Holder’s Name as it appears on card _____________________________________

C. Stocks and/or Securities
   □ Please have someone call; I/we wish to discuss a gift of appreciated stock and/or securities to avoid
     capital gains taxes.

D. Reminder
    Please send me reminders to pay my pledge on ___/___/___

E. Recognition
    This is how I/we would like this gift to be acknowledged:
         (Please print name(s) as you want it to appear in donor recognition materials)
    I/we would like to discuss a naming opportunity.
    Please do not publish name in donor recognition materials; I/we prefer to remain anonymous.
    This gift should be credited to the following Challenge:

Signature ___________________________________ AGEHR Member No._______________

Preferred Mailing Address

City, State, Zip
Telephone                                          E-Mail
Date _______________________
                                                                                     Click to Submit Form

                                1055 East Centerville Station Road
                                      Dayton, Ohio 45459
                           937-438-0085 (phone)  937-438-0434 (fax)
                                Or e-mail to:
         Gifts Paid Over a Three-Year Pledge Period

 Gift            Paid Annually           Paid Quarterly           Paid Monthly
$7,500               $2,500                   $625                    $208
$5,000               $1667                    $417                    $139
$2,500                $833                    $208                     $69
$1,500                $500                    $125                     $42
$1,000                $333                     $83                     $28
 $750                 $250                     $62                     $21
 $500                 $167                     $42                     $14
 $250                  $83                     $21                      $7
 $100                  $33                      $8                      $3

   All gifts are tax-deductible. Gifts of appreciated stock are encouraged.

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