Credit Card: Visa. MasterCard. Discover ... authorization for any additional unrelated debits or credits to your credit
MY PLEDGE
First Name:_________________________________ Last Name: _________________________ I/We Pledge to #GivetotheHome on #GiveMiamiDay in the Amount of: 10,000
$
100
$
$ $
5,000
$
2,500
$
75
$
1,000
50
$
750
$
500
$
250
$
25 (minimum)
Other amount (greater than $25) __________
Credit Card:
Visa
MasterCard
Discover
AMEX
Cardholder Name: ______________________________________________________________ Account Number: _______________________________________________________________ Expiration Date: ______________ CVV2: ____________ Billing Address: ________________________________________________________________ City: _______________ State: ____ Zip Code: __________ Phone: ______________________ Email: ______________________________________________ Completed form can be sent to Jenny Ray, Senior Development and Donor Relations Manager at
[email protected] or 305 762 1382 or 305 898 5602.
Please note: This is permission for a single transaction only, and does not provide authorization for any additional unrelated debits or credits to your credit or debit card.
A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-435-7352 WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE. REGISTRATION NUMBER CH34102 ALL GIFTS ARE TAX-DEDUCTIBLE AS PROVIDED BY LAW.
