Build the Future Gift Commitment Form

Build the Future is about extraordinary pride in a school; it's about vision; it's about tradition; it's about community; it's about excellence. But most importantly it's about inspiring children to dream and helping them reach the fullest extent of their potential. Thank you for your support!

Personal Information
Name:

Address:

City:

State:   Zip:

Phone:   E-mail:

Contact Person (if applicable):

Best Time to Contact (if applicable):

Pledge
I/We hereby pledge a financial gift to Lafayette Jefferson High School's Built the Future Campaign.

My/Our gift will be made as follows:

Annual Gift: X Years = Total Gift:

Annual Payment Date:

I would like my reminder notice to be sent in month(s).

Payment schedules other than annual may be arranged.

Gift/Pledge Designation - Phase I  
Rohrman Center for the Performing Arts John B. Scheumann Stadium

Space to be named within a facility:
(Please refer to the Commemorative Naming Opportunities chart for specific facilities that are available.)

Name to be used on facility:

Form of Payment  
Cash or check MasterCard Visa Securities
(For payments using MasterCard or Visa, please send the amount you would like to donate along with: card type, card number, expiration date, name as it appears on the card, a statement giving approval for the charge and a signature and date to the address below.)
 
For Scheumann Stadium,
Make checks payable to:
Golden Bronchos Club, Inc.
For the Rohrman Center,
Make checks payable to:
Lafayette Jefferson Band Boosters, Inc.

Pledge Authorization

Name:

Signature: (Please enter your initials in this box to indicate agreement with the pledge entered above)

Date:


Please hit the submit button only once
 
If you are using AOL, you cannot use the SUBMIT button at the bottom of the form. You will need to copy the text from this form and paste it into a new email message. You will then be able to enter text at the appropriate places. Email should be addressed and sent to chuck@reedcpa.com

Copyright ©2003