WPL - Website - Pledge Form

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In recognition of the vital role the Wells Public Library plays in the intellectual, cultural and social

enrichment of our citizens, and the need to provide a larger, improved facility for expanded materials,
services and programs for our community, I/we are pleased to support the WPL Growing Again Campaign.
I/We will contribute a gift of $ __________________ to be paid over a period of ___________ years.
Name (Mr., Mrs., Dr., Ms., Miss) ________________________________________________________________________________
Mailing Address ____________________________________________________________________________________________
Telephone __________________________________________ Email _________________________________________________
Designate my/our gift as follows: A Gift from ______________________________________________________________________
(please indicate how you prefer your name/s to be recorded if different from above)
(optional)

In Honor of _____________________________________ In Memory of __________________________________________


This gift is unrestricted.

This gift is to sponsor: _________________________________________________________

Enclosed is payment of $ ___________________________


Please make check payable to: WPL Growing Again Campaign

If you wish your donation or pledge payments to be paid


by credit card, please provide the required information
on the form below.

This is a pledge with payments to be made in the


following amounts:
2015 $ _________________
2016 $ _________________
2017 $ _________________

My employer has a matching gift program. I will submit


the proper forms to the address below.

Pledge payments will be made:


Annually
Semi-Annually

Charge my/our gift and pledge payments to my credit


card.

Signature ___________________________________________

Quarterly
Monthly

Date ________________________________________________

Please return this card to: Wells Public Library Foundation, WPL Growing Again Campaign, 1434 Post Road, Wells, ME 04090.
Your donation and pledge payments are tax deductible. Thank you for your support!
To protect your privacy and the security of your credit card information, this authorization
form will be detached and destroyed after your credit card payment is processed.

CREDIT CARD AUTHORIZATION FORM


I/We wish to contribute to the WPL Growing Again Campaign with credit card payments of $ _________________to be made
one-time

monthly

quarterly

semi-annually

annually in ______________payment(s) for a total gift


(number of)

of $ ________________________. The Wells Public Library Foundation is authorized to make these deductions beginning
on _______________________________ from my
(month and year payments are to begin)

Visa

MasterCard

Discover

American Express

Account # _________________________________ Exp Date _____________ Security Code (on back of card) ______________
Name (as it appears on card) ________________________________________________________________________________
Billing Address(if different from pledge card) ______________________________________________________________________________

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