Page 14 - Beta Theta Pi - Campaign - University of South Carolina

Campaign Pledge Agreement - Non Tax Deductible (For Pledges Below $5,000) I, _____________________________________________, accept the invitation to join my brothers in support of our fraternity in its mission to develop men of principle for a principled life. I hereby do pledge and agree to contribute the sum of $______________________ as part of the Building A Bridge for Our Future Campaign of the Upsilon Chapter of Beta Theta Pi, Inc. My gift will be paid in the following manner: m One-time payment m Quarterly (Jan/Apr/Jul/Oct) } Plan to be paid over m Semi-annually ________________ years m Annually [Maximum 5 Years] m Stock (publicly traded) m Other: m I am affliated with a company that has a matching gift program. Employer: ________________________________________ Start Date (please circle one): January April July October 20 _______________________________________ Signature: ____________________________________________________________ Date: __________________________________ Print Name: ________________________________________________________ Initiation Year: _______________________________ Preferred Address: ________________________________________________________________________________________________ City: _________________________________________________________ State: ___________________ Zip: _____________________ Home Phone: ____________________________________________ Work Phone: ____________________________________________ Cell Phone: ___________ ________________________________ E-mail: _________________________________________________ Gift to be made: m In my name as printed above m In honor of: m In memory of: Payment Method: m Check m Stock (publicly traded) m Credit Card: ____ Visa ____ MasterCard ____ American Express ____ Discover Credit card payments will be automatically deducted according to the payment schedule below. Please select one: m monthly m quarterly m semi-annually m annually Account No.: Exp. Date: Signature: Note: Please make check payable to “Upsilon Chapter House Corporation.” † Contributions to the Upsilon Chapter House Corporation are not deductible as charitable contributions for federal income tax purposes but are essential in achieving the goal of con- structing both the educational and the non-educational areas of the chapter house. Gifts or pledges other than cash are subject to the acceptance of the Upsilon Chapter House Corpora- tion. Please consult your attorney, CPA, and/or certifed fnancial advisor for professional advice regarding this pledge. Please send this Pledge Agreement to: For further information, please contact: Building A Bridge for Our Future Jamie Haas, Account Manager The Campaign for Upsilon of Beta Theta Pi T: 770-903-3987 F: 770-903-3988 Campaign Headquarters E: JHaas@thelaurusgroup.net P.O. Box 80828 | Atlanta, GA 30366-0828