Agawam Council · Campaign Pledge Form

Agawam, My Agawam campaign pledge

I/We pledge the following amount to the Agawam, My Agawam campaign, over a maximum of four years:

*

My/our pledge will be paid in the following installments:

In 2020

In 2021

In 2022

In 2023

This pledge will be paid

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Annually in the month indicated

Monthly

Semi-annually in the months indicated

Other

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Indicate month(s) of pledge payment

The first payment:

*

Will be paid immediately, online (below)

Will be paid immediately with a check payable to Agawam Council

Will be paid on the date indicated below

Date first payment will be sent:

(mm/dd/yyyy)

Donate now! Enter online gift payment amount

$

Donation Schedule

Additional Donation Options

Please provide information for donating appreciated stock

I would like to learn more about designating my pledge to a specific purpose within the campaign goals

I/We have included Agawam in our estate plans and agree to be listed in the Hiawatha Society

I/We would like more information about the Hiawatha Society

I/we anticipate that this gift will receive a corporate match

Name of company matching pledge

Contact Information

Name

*

First Name

Last Name

Email

*

Verify Email

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Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone

*

Donor Recognition

*

Please enter how you would like your name(s) to appear in printed recognition materials. If you wish your gift to be anonymous, please write “anonymous” above.