Pledge Confirmation

Fill this in on screen, then print it to sign and return. Nothing you type is sent anywhere — the form works entirely in your browser. To give online instead, visit the Pickaway County Community Foundation donation page.

Your gift to the Pickaway Agriculture and Event Center Fund will be recognized as:

Donor Name

Address

City, State

Zip

Phone

I/we wish to have our gift remain anonymous

Your gift

My gift of $ — is enclosed

My total pledge is $

which I intend to pay by

(Gifts may pledged over a multi-year period)

Our gift will be made through a donation of grain

Loads

or bushels

or $

over (years)

Pledges may be invoiced

Monthly
Quarterly
Semi-annually
Annually

Please begin payments on

Credit card

Card details are deliberately not typed into this page. Print the form first, then write them on the printed copy and return it to the Foundation, or give online through the Foundation's secure payment page.

Amex
Visa
MC
Discover

CC# (write on the printed copy)

Exp. Date (printed copy)

Sec Code (printed copy)

Name as it appears on card

Please make checks payable to: The Pickaway County Community Foundation

To make your gift online, please visit: yourpccf.org

Gifts of securities, bequests, and other planned gifts are also accepted. Please contact Jan Shannon at jan.shannon@yourpccf.org to learn more.

Signature (sign after printing)

Date

Please return to

The Pickaway Agriculture and Event Center
C/O The Pickaway County Community Foundation
770 North Court Street, Circleville, OH 43113

Thank you for your generosity and support!

No goods or services have been or will be received for this contribution.

Sign the printed copy and return it to the Foundation at the address above.