Capital Campaign Pledge Form

Donating to the campaign is easy to do, especially by breaking up your gift into a three-year pledge. Use this form to make a pledge to our WCHS Building Our Future campaign. To make an immediate online donation, please use our Online Donation Form instead. Thank you!

Interested in a naming opportunity? Please view the list of Naming Opportunities available.

If you would rather mail in your Pledge, please print the form and send it to: WCHS, PO Box 397, Brattleboro, VT, 05301

My Pledge: Naming & Donation Opportunities

Confirming my/our commitment to the Building A Better Future campaign, I/we pledge the sum of:

[*Note minimum annual pledge payment amount is $1,000, and the maximum pledge period is three years.]

How would you like to fulfill your pledge?

1. This is my pledge, paid in full.

Check yes, if this is accurate.

2. I will fulfill my pledge by:

Please select a date

YYYY

3. I will fulfill my pledge by making this many payments...

Please identify # of payments:

...in the amount of:

Please identify your payment amount:

4. I will fulfill my pledge through a gift of securities or another investment vehicle.

Please specify the type of investment vehicle:

The approximate value of these investments:

5. My company will match my gift in the amount of:

Naming Opportunity

I have reviewed the list of Naming Opportunities associated with a gift at the level indicated above and would like to name the following Room or Item:

(If the Naming Opportunity is unavailable, I understand you will be in touch to discuss other opportunities.)

Inscription: Up to 3 lines, 25 characters per line. You are welcome to dedicate the space in honor/memory of a pet or person, or company.

(Note: signage can vary depending on location or other factors. We will notify you if there is a need for you to modify your inscription.)

Contact information

Name

First Name

Last Name

Postal Address:

Phone

(###)

###

####

Comments/Message

If you would like to make a donation by check, please make payable to WCHS and send to:

Windham County Humane Society
Attn: Building Our Future Campaign
PO Box 397, Brattleboro, VT 05302