Issuu on Google+

2011 DUKE CLUB PLEDGE CARD Full Name:

Give Online at DUKEDOGPRIDE.COM 2011 Pledge: $

Address:

Only charge $_________ of my pledge now.

City/State/Zip:

My employer/spouse’s employer will match my gift. You must submit a matching gift form. All expected matches are included in pledge amount and must be paid in full by 12/31/11.

Company Name:

Customer #

Preferred Phone: (Circle One)

Cell

Home

Business

I would like to pay in full.

Expected Match:

Preferred Email:

Benefits & Taxes

Referred By:

I am declining ONLY hospitality benefits.

Select Payment Option:

I am declining ALL benefits associated with my donation. Including priority ticket(s) and priority parking based on Duke Club ranking.

Enclosed is my CHECK made payable to: JMU Foundation

I would like to make my gift via a monthly payment.

Please charge my CREDIT CARD (Circle One) American Express Mastercard

Discover

Please charge my checking account* $ (*Please include a voided check.)

Exp. Date

Routing Number

Former Student-Athlete/Sport:

Credit Card No.

Grad Yr:

Visa

on the 20th of each month.

Checking Account Number

JMU Duke Club ~ MSC 0402, 380 University Blvd., Harrisonburg, VA 22807 ~ (540) 568-6461

2011 Duke Club Pledge Card