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Southeastern Credit Union Foundation Pledge Form Pledge from (select one): ________ Credit Union/Company/Organization ________ Individual – personal donation Please use our contribution in the following way(s): All-Purpose Fund ……………………………………………………………………………. $______________ Provides educational scholarships for credit union staff and officials for professional development and grants to related organizations focused on professional development, financial education and industry specific research.

Disaster Relief Fund ………………………………………………………………………… $_______________ Provides immediate assistance to credit unions, staff, volunteers and communities impacted by natural disasters.

Credit Union for Kids Contribution ..…………………..……………………………………. $_______________ Provides funding to Children’s Miracle Network hospitals serving credit union communities in Alabama and Florida. These contributions are used to support research and training, purchase equipment, and pay for uncompensated care, all in support of CMN’s mission to save to improve the lives of as many children as possible.

Amount Enclosed

$_______________

Name: _____________________________________________________________________ Name:______________________________________________________________________ Credit Union: ________________________________________________________________ Credit Union:_________________________________________________________________ Address: ___________________________________________________________________ Address:_____________________________________________________________________ _________________________ State: _______ _______ Zip: _________ Chapter: _____________ City: _________________________ City:_________________________ State:______ Zip:________ Chapter:_______________ Payment Options Options:

ACH/Wire to SECUF Disaster 263182516 ACH to SECUF Disaster ReliefRelief Fund Fund ABAABA#: #: 263182516

Check Check (See (See mailing mailing address address below) below)

Account#: 9120000132522

ThankstotoYOU YOUfor foryour yourcontinued continuedsupport. support. Thanks

TheSoutheastern SoutheasternCredit CreditUnion UnionFoundation Foundationwill willbe berecognizing recognizing all all donors donors on on the the SE SE CU CU Foundation Foundation website website and The Southeastern Credit Union Foundation will be recognizing all donors on the SE CU Foundation website and at at the the LSCU LSCU AC&E. AC&E. The

We need to FAX a copy of this form totoAmber R Tynan at 850.558.1155 prior to sending in your donation FAX ayou copy of the pledge formpledge in addition mailing with payment to Amber R. Tynan at 850.558.1155 in order for us to apply your donation appropriately. Mail check payments to: Mail check payments to: League of Southeastern Credit Unions League of Southeastern Credit Unions ATTN: Accounting ATTN: Accounting P.O. Box 3108 P.O. Box 3108FL 32315 Tallahassee, Tallahassee, FL 32315

For wire transfers, use this address: For wire transfers,Credit use this address: Florida Commerce Union Florida Commerce Credit Union 1620 Futura Dr. Suite 100 1620 Futura FL Dr. 32317 Suite 100 Tallahassee, Tallahassee, FL 32317 C/O Southeastern Credit Union Foundation C/O FAX:Southeastern 850.558.1155Credit Union Foundation


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