Name:_________________________ Date:__________ Phone:________________ Email:__________________
Address:_________________________________________City:_______________ State:____ Zip:________
□Check/Money Order Enclosed $_____________ □Installments of $_____________ (Monthly, Quarterly, Semi-Annually, Annually)
□I wish to charge a gift of $_________________to my VISA or MASTERCARD (Circle one)
Card Number:__________________________________ Security Code:_______ Exp:_________
Name on Card:_____________________________Signature:_____________________________
Please see reverse to donate property, stocks, or to make a pledge.
CAPITAL CAMPAIGN GIFT FORM
755 Myra Road, Walla Walla, WA 99362
(509) 525-7703 Fax (509) 525-7798
FORMAL PLEDGE ACKNOWLEDGEMENT
□I,_____________________pledge a total of $___________ to be paid by __________ □Please send pledge reminder
(To take full advantage of matching funds, gifts must be paid by 12/31/09)
Pledge Signature___________________________________________________________
STOCK/PROPERTY TRANSFER
□I will transfer ___________ shares of _______________________________________ On:___________________
□I will donate the following assets ____________________________________________On:___________________
Thank you for supporting Fort Walla Walla Museum!
(Contact Fort Walla Walla Museum for instructions on transferring stock and/or property)
Heritage is the thread that binds the fabric of a community together