ST. CHRISTOPHER SCHOOL ANNUAL FUND

Pledge/Donation Form

 

My gift is $_________  [  ] Paid in full    [  ] Paid in 3 installments              [  ]   If you do not wish your name to be published, please indicate here. 

 

[   ] In memory of ___________________________       [  ] In honor of ____________________________                  [  ] Eligible for Matching Gift

 

NAME                                                                                                    MAIDEN NAME (If alumna)

 

ADDRESS

 

PHONE                                                                  E-MAIL                                                                  OCCUPATION

 

[  ] Alumni             [  ] Parent               [  ] Past Parent                      [  ] Grandparent                     [  ] St. Christopher Parishioner         [  ] Friend

 

[  ] I authorize use of my credit card for payment in the amount of $ __________   [  ] VISA [   ] MASTER CARD Card # ______________________

 

Exp. Date ______________________  Signature _____________________________________   Date ___________________________

 

Please indicate your gift choice:

[  ] Platinum Society   $ 2500 or more                  [  ] Benefactor      $1000 to $2499          [  ] Principal’s Circle   $500 to $999         

[  ] Maroon & Gold    $250 to $499         [  ] Century Club   $100 to $249           [  ] Donors Club           $50 to $99              [  ] Giving Circle up to $49

Please mail form to: St. Christopher School, 570 Brewer Street, East Hartford, CT  06118

 

 

If you'd prefer Adobe format click here: Adobe Pledge Form  To view and print this form, you will need to have Adobe Acrobat Reader installed on your computer. It is a free download

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