Donor Pledge Form

This form is used to formally pledge your commitment for ongoing and future donations to Secure Beginnings.

If you prefer a paper form, please print, sign, and mail this pdf Donor Pledge Form.

Donor Information

Name

First Name

Last Name

Verify Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Please list my/our gift using this donor name :

... or :

I/We prefer to remain anonymous

Pledge information

Starting

(mm/dd/yyyy)

... through

(mm/dd/yyyy)

... I / We plan to make recurring donations to Secure Beginnings every

Month

Quarter

Year

... and each donation will be $____.

My / our total pledge over this period of time is $ ___.

Unrestricted gifts will be applied to the area of greatest need unless directed otherwise.

I / We prefer to direct my / our gift to this program:

(Unrestricted)

ParentCare

Parent Consultations

Classes

Diaper Bank

Counseling

Latino Programming

PAYMENT

I / We will mail payment(s) by check, payable to Secure Beginnings, to PO Box 285, Ojai, CA 93024

I / We will make a secure credit card payment online at securebeginnings.org/donate (and set payments as recurring if applicable)

Please call me to complete credit card payment via phone

Electronic Signature: By typing my name here, I am signing this pledge to support the work of Secure Beginnings.