Online Gift Pledge Form

Contact Information

First Name:		Telephone
Middle Name:		Home Phone:
Last Name:		Work Phone:
Address:
City:		State:
Zip:		E-mail:

Gift Pledge My Pledge Gift Amount is: $

Gift Type My pledge is a:
One time gift
Annual Gift to be donated each year for (years).
Endowment Gift to be invested in perpetuity.
Planned Gift (please describe)

Gift Designation My gift is designated for:
   Annual Fund
   President's Fund
   General Scholarship Fund
   Alumni Association Scholarship Fund
   New Scholarship Fund (to be specified by donor)
   Faculty Support (specify department/field of study)
   Academic Program Support (specify field of study)
   Capital Improvements (specify area)
   Other (please specify)

Gift Name (if applicable) My gift is to be named:
In honor of:
In memory of:

Gift Contact The contact person for my gift is (if different from the Donor Information):

Gift Recognition Yes, I authorize Silver Lake College to publicize receipt of my gift in the Annual Report
No, I prefer that my gift and my role as the donor remain anonymous

Gift Payment My gift will be donated on or about (specify month):
In the form of:
Check
Credit Card
Transfer of Stock
Gift-in-Kind (please describe)
Other (please specify)

Reminder Please mail a reminder one month before my pledge is due.
Please call with a reminder one month before my pledge is due.

Silver Lake College is a 501(c)(3) non-for-profit institution. Contributions are tax deductible as allowed by the Internal Revenue Service of the U.S. Government and State of Wisconsin.

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