Capital Campaign Pledge Form

Donating to the campaign is easy to do, especially by breaking up your gift into a three-year pledge.

Use this form on this page to make a pledge to our WCHS Building Our Future Campaign.
To make an immediate donation, please use our Online Donation Form instead.
Interested in a naming opportunity?

If you would rather mail in your Pledge, please print the form and send it to:

Windham County Humane Society
Attn: Building Our Future Campaign
P.O. Box 397, Brattleboro, VT 05302

Form: Capital Campaign Pledge Form Form

My Pledge: Naming & Donation Opportunities

Confirming my/our commitment to the Building A Better Future campaign, I/we pledge the sum of:

*Note minimum annual pledge payment amount is $1,000, and the maximum pledge period is three years.

$

I will fulfill this pledge by this date:

Please select a date

MM

DD

YYYY

In the amount of:

Please identify your payment amount:

$

I will fulfill my pledge by making this many payments:

Please identify # of payments:

I will fulfill my pledge through a gift of securities or another investment vehicle.

Please specify the type of investment vehicle:

The approximate value of these investments:

5. My company will match my gift in the amount of:

$

Naming Opportunity

I have reviewed the list of Naming Opportunities associated with a gift at the level indicated above and would like to name the following room or item:

(If the Naming Opportunity is unavailable, I understand you will be in touch to discuss other opportunities.)

Inscription: Up to 3 lines, 25 characters per line. You are welcome to dedicate the space in honor/memory of a pet or person, or company.

(Note: signage can vary depending on location or other factors. We will notify you if there is a need for you to modify your inscription.)

Contact Information

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

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