As a member of the College of Agriculture and Life Sciences family,

I accept the invitation to help the victims of Hurricane Floyd

Floyd Relief

Pledge Intention Form

My Total Gift Amount Will Be: $___________.

______ Please designate $_____ of my gift for the CALS Floyd Relief Fund (100% of these funds will directly benefit Eastern North Carolina families and communities impacted by Hurricane Floyd).
______ Please designate $_____ of my gift to support the NCCESF Benevolence Fund (100 % these funds will directly benefit Extension families impacted by Hurricane Floyd).
______ Please designate $_____ of my gift to support the NCDA Farmer Disaster Fund (100% of these funds will directly benefit agriculture and farm families impacted by Hurrican Floyd.)

A check for the total amount of $_______ is enclosed.

I would like to charge my entire gift amount. Card Type: ___Visa ___MC

Name as it appears on card:_________________________________
Card Number:_____________________________________ Expiration Date:_________


A check for $________ as my first payment is enclosed. A balance of $________ remains on my pledge and will be paid in equal annual installments over the next two years.

I am enclosing a completed Payroll Deduction Form. Each month for the next ___ (1-2) year(s) $_______($10 min.) will be deducted from my paycheck.

(Print) Name________________________________________________________________

Phone__________________(Day) ___________________(Eve.) FAX________________ Email_______________________ Website:______________________________________

Address (campus and home)_______________________________________________



Please make checks payable to The North Carolina Agricultural Foundation (Tax ID # 56-6049304)
(you will receive an official receipt for your contribution,
and pledge reminders if you have chosen that option).
Send to: Floyd Relief Fund, c/o NC Agricultural Foundation, Box 7645, Raleigh, NC 27695 or FAX to 919-515-5274.
If you have any questions or require additional information,
please call Sandy Zaslow at 919-515-2781 (
or Chris Cammarene-Wessel at 919-515-7678 (