Mission Valley Aquatics |
Donation/Pledge
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Name(s)_______________________________________________________________
(print name as to appear for recognition)
o Remain Anonymous (mark the circle to indicate you would like to remain anonymous)
Address_______________________________________________________________
City/State/Zip__________________________________________________________
Phone (____)______________ E-mail ______________________________________
o I have enclosed a gift of $ _______________.
o Or I wish to pledge dollars to be paid by September 1st each year as follows:
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Payment Schedule
Year Amount2006 $_________ 2007 $_________ 2008 $_________ 2009 $_________ 2010 $_________
Total $_________
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Total Levels of Giving:
Individual Medley $100,001 or more Butterfly $50,001 to 100,000 Backstroke $10,001 to 50,000 Breaststroke $5,001-10,000 Freestyle $1001-5,000 Sidestroke $251-$1000 Treading Water $50-$250 |
o I would like to donate materials, services, securities or real estate.
Description:_____________________________________________________________________________________________________________________________________________________________________________________________________
Authorized Signature:__________________________________ Date:______________
Mission Valley Aquatics is a non-profit organization. All gifts, donations and bequests are Federal & State Tax Deductible.
PLEASE MAIL COMPLETED FORM TO:
Mission Valley Aquatics If you have any questions please call 883-4567
P.O. Box 774 or e-mail: mvaquatics@polson.net
Polson, Montana 59860 Visit our website at www.mvaquatics.org