Page 5 - Theta Chi SDSU Undergraduate Packet

Building for Our Future Campaign for Gamma Theta Chapter of Theta Chi Campaign Headquarters | P.O. Box 80828 | Atlanta, Georgia 30366 | 770-903-3987 | 770-903-3988 Fax Undergraduate Pledge Form Campaign Giving I, _______________________________, accept the invitation to join my fellow fraternity brothers in our continued Levels support of Theta Chi and its mission of providing an opportunity for collegiate men to develop and learn skills that will aid them throughout their lifetime. To show my support of these efforts, I do hereby pledge and agree to Founder’s Society contribute the sum of $______________________________ to the Gamma Theta Alumni Association for their $100,000 + use in association with the design and construction of our new chapter house. Military Red & My gift will be paid in the following manner: White Society m One-time payment Plan to be paid over $50,000 - $99,999 m Quarterly (Jan/Apr/Jul/Oct) } ________________ m Semi-annually years/months Red Carnation Society m Annually [Maximum 5 Years] $25,000 - $49,999 m Stock (publicly traded) m Other: ___________________________________________________ Aztec Society $10,000 - $24,999 m I am affliated with a company that has a matching gift program. Employer: _______________________ Start Date (please select one): January April July October 20 ______________ Sword & Serpent Signature: ________________________________________________ Date: ____________________ Society Print Name: _________________________________________________ Graduation Year: __________________ $5,000 - $9,999 Preferred Address: __________________________________________________________________________ November 8th Society City: __________________________________________ State: ____________ Zip: _________________ $2,500 - $4,999 Home Phone: ____________________________________ Work Phone: ____________________________________ Cell Phone: ____________________________________ Email: ________________________________________ Norwich Society Gift to be made: m In my name as printed above $1,000 - $2,499 m In honor of: ________________________________________ m In Memory of: ______________________________________ Payment Method: m Check m Stock m Credit Card: ____ Visa ____ MasterCard ____ American Express ____ Discover Account No.:________________________________________________ Exp. Date:_________________ Signature: ____________________________________________________________________________ m This is a one-time credit card payment m Please automatically charge my credit card according to the schedule outlined above Note: Please make check payable to “Gamma Theta Alumni Association” Please send this Pledge Agreement to: For further information, please contact: Building for Our Future Sam Craig, Account Manager The Campaign for Gamma Theta of Theta Chi T: 770-903-3987 Campaign Headquarters F: 770-903-3988 P.O. Box 80828 | Atlanta, GA 30366-0828 E: SCraig@thelaurusgroup.net