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ANCA Pledge Form
Your pledge, made before June 30, will help us meet our fiscal year goal!
Address Line 1
Address Line 2
I would like to:
Make a pledge now and pay in full at a later date.
Make a pledge to be a Sustaining Donor to be payed in installments.
Make a pledge now and pay with securities. (please call Jen Levy at 435-787-8209)
NOTE: You will receive reminders prior to pledge payment date(s) and will have the option to pay with a credit card online (and save your card for future payments), send a check, or call the ANCA office with a credit card.
Richard Haley Memorial Scholarship Fund
ANCA Operational Reserve
Bridging the Gap Campaign
Use Gift as Needed
Total Pledge Amount
Pledge Payment Schedule
If pledging to pay later or in installments as a Sustaining Donor, please tell us when you will pay in full or if you wish to pay monthly or quarterly, how much you would like to pay each time, and when to start and stop your reminders. For example, "I will pledge to pay $50 monthly starting July 2019 and ending in June 2020."
I will mail a check payable to ANCA
I will pay by Credit Card, please send an invoice
Securities, I will call the ANCA Office
Mail Checks to: ANCA, PO Box 464 Logan, UT 84323
Is your donation:
In memory of someone?
In honor of someone?
None of the above?
My gift is in memory of:
My gift is in honor of:
Please send acknowledgment to:
My gift is eligible for a matching gift. Please contact me.
Questions? Call us at 435-787-8209