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The Village People - "Presenting West Salem" Pledge Form...

 

TAX DEDUCTIBLE...
Contribution Levels...
  • $5,000 plus -
    Pillar of the Community
  • $1,000 plus -
    Community Philanthropist
  • $500 plus -
    Community Benefactor
  • $100 plus -
    Community Partner
  • Up to $100 -
    Community Investor
PRINT OUT THIS PAGE AND MAIL YOUR CONTRIBUTION TODAY!
Keep a copy of this form for your records.>
Amount Pledged:

Name:

Business:

Address:

City:

State:

ZIP:

Phone:

E-mail:

Signature:

Enclosed is my/our contribution of:

I/we wish to pledge this amount:
Monthly Yearly

I am interested in auto withdrawl from my bank. Please contact me:
I wish to reamin anonymous
I wish to volunteer my time in this effort

Please make checks payable to:
The Village People
P.O. Box 10
West Salem, WI 54669
Thank You for your support!