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Multiyear Pledge Form
Pledge Form
Review and Sign
Contact Information
First Name(s)
*
Last Name
*
Select preference: I (we) want to be
recognized publicly
listed as anonymous
Recognition Name
Preferred Phone
*
Preferred Email
*
Address
*
Address
Street Address
Street Address
Unit #/Street Address Line 2
Unit #/Street Address Line 2
City
City
State/Province
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State/Province
Zip/Postal
Zip/Postal
Address
Pledge Information
Method of Contribution
*
Check
Donor Advised Fund or IRA Distribution
Stock or Securities
Credit Card
Legacy Gift
Other
Other
*
What is the other method you would like to contribute by?
I/We pledge a total of
*
total
to the United Way of Greater New Haven
United for the Future Campaign
to be realized over (years)
1
year(s)
1
year(s)
5
year(s)
Commencing On
*
I/ we would like to contribute in installments
Annually
Monthly
Legacy Gift Type
*
Bequest through Will
Beneficiary on Retirement Account
Beneficiary on Life Insurance Policy
Other
Other Legacy Gift Type
*
Notes About My/Our Gift
0
of 250 max characters
Annual Impact
Please also renew my/our annual gift
No
Yes
Annual Gift Amount
*
$
per year
Number of Years
*
1
year(s) after
1
year(s) after
5
year(s) after
How many years would you like your annual pledge to renew for?
If you are human, leave this field blank.
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