Story Builder Campaign Pledge Form

Name*

Prefix First Middle Last

Business/Organization (if applicable)

Address*

Street Address Address Line 2 City State ZIP Code

Business Phone

Home Phone*

Email

Please use the following name(s) in the "Donor Recognition" opportunities:

Option to remain anonymous

I (we) wish this donation to remain anonymous.

Total Pledge (Minimum $1000):*

I (we) pledge a total of

To be paid:*

Annually
Bi-Annually
One time gift

The minimum pledge is $1000 annually unless paying by credit card. You can choose to set up recurring credit card payments.

Over the course of:*

2 years
3 years
4 years
5 years

This gift is a tribute (optional)

In honor of
In memory of

Name of person being honored

Group gift

If you are combining your gift with others, please indicate the individuals, organization, or group.

Donation Information

Check (made out to ECCF/Story Builder Campaign)
Credit card (Visa, MasterCard, Discover, and AMEX)
Qualified Charitable Donation
Stock transfer
ACH
In-kind donation

Recognition opportunities do not reflect the exact cost of any item, but rather the level of recognition commensurate with the size of the gift. No goods or services of substantial value will be provided in exchange for a gift.

Employer matching gifts (optional)

My (our) employer will match employee contributions.

Name of Employer

Electronic signature acknowledging pledged contribution*

Date

Additional Notes

ECCFWI

Yes! I'd like to donate to the L.E. Phillips Memorial Public Library's Story Builder Campaign!