Florida Alpha - Phi Delta Theta · Parking Lot Campaign Pledge Form

Brother Member and Contact Information

Name

Prefix

First Name

Last Name

Suffix

Bond Number

Pledge Year

Pledge Class Semester

Email

Verify Email

Preferred Phone Number

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Campaign Committment and Payment Schedule

I pledge to give to the Parking Lot Campaign:

I accept the invitation to join my brothers in supporting the future of Florida Alpha and hereby do pledge and agree to contribute to the Campaign for Florida Alpha in the sum of:

I will pay my pledge in payment(s):

One Time Payment

Other

If not paying in one payment, please indicate your preferred payment schedule. *

We request that your commitment is completed as soon as possible.

In honor or in coelo quies est

Gift to be made:

Anonymously

In my name entered above

In memory of: (Enter name )

In honor of: (Enter name )

Name of honoree or brother in Chapter Grand

Payment Information

After you submit your form, a confirmation page will provide you the opportunity to use a credit card to create a recurring payment schedule. Please click the donate button and follow the prompts if you will make your commitment by credit card.

If you prefer to pay by check, please send checks to:

Florida Alpha PDT Capital Campaign
PO Box 1880
Tuscaloosa, AL 35403-1880

If you have any questions, please contact a campaign volunteer or email us at info@pdtfla.org.

Thank you for accepting the invitation to join others in support of our fraternity!

Please note that gifts to the Florida Alpha Chapter of Phi Delta Theta are not considered tax-deductible by the IRS. If your situation requires a vehicle to make a tax-deductible gift, please contact that campaign administrator Don Souhrada via email at info@pdtfla.org.