My Total Gift Amount Will Be: $___________.
__A check for the total amount of $_______ is enclosed.
__I would like to charge my entire gift amount. Card Type: __American Express __Discover __Mastercard __Visa
Name on Card:_______________________________ 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 ___ (1-5) years.
__I am enclosing a completed Bank Draft Authorization Form. Each month for the next ___ (1-5) year(s) $_______($10 min.) will be deducted from my account.
__I am interested in learning more about establishing named
endowments. Please call me during the:
Phone___________________(Day) ___________________(Eve.) FAX____________________
Send to: NC Agricultural Foundation, NCSU Box 7645, Raleigh, NC 27695.
Or, you may fax your forms to 919-515-5274.
If you have any questions or require additional information, please call Gerald Havenstein at 919-515-5555 (email@example.com) or Chris Cammarene-Wessel at 919-515-7678 (firstname.lastname@example.org).