EmailMe Form - USWT Founders Charities Pledge

USWT Founders Charities Pledge

Donations to the USWT Founders Charities are greatly appreciated, and can be done at any time.

In-kind gifts or services are also appreciated and may be contributed in the same manner as cash. A statement of current fair market value should accompany the gift.

Signatures can be done by your mouse, or your finger on a writable screen.

Responses to the online form will be viewed by the USWT Founders Charities President. Fill in as much information as you know. Upon completion of the form, click Submit; you will receive a confirmation screen if your form has been successfully submitted. (rev 2017)

Your Email *
Name *
First Last
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone
### - ### - ####
Contributor *
I will pledge my support to the USWT Founders Charities by investing in: *
$100 for Curator Membership
$25 for Curator Membership Payment Plan
Amount listed below for the Chapter Grant Program
Amount listed below as a Friend of US Founders Charities
Amount listed below for the Scholarship Program
Pledged Amount *
$ Dollars . Cents
Indicate how your contribution should be recorded: *
Individual
Chapter Organization
State Organization
Corporation or Business
In Memory of the person/organization listed below
In Honor of the person/organization listed below
Please record my gift as an anonymous contribution.
Other
Chapter *
State Organization *
Other State Organization *
Please enter the State Organization if you chose "Other" above
Contribution Description *
Signature
Clear
By signing, I agree to follow through with this pledge.