NWACC Foundation

Pledge Form

(Print this page, fill out and return to the address below)

Donor Information

Name ______________________________________________________

Address _____________________________________________________

City/State/Zip ______________________________ Country ___________

Home Phone _______________________ Email _____________________

Gift Amount

___ This is a payment on an existing pledge. Amount enclosed: $_________

___ I am a new donor. My/Our pledge of $________ will be paid as follows:

Amt/Yr. $_______ x No./Yrs. _____ = Total Pledge $________

Method of Payment

___ Cash/Check (made payable to the NWACC Foundation - BUilding The Future)

___ Visa/MasterCard No: _______________________ Exp. ___________

Name on card ___________________________________________

Signature (authorizing automatic charge of above schedule)

______________________________________________________

Designated Fund

___ My/Our pledge is designated for a specific fund:____________________

Matching Gift

___ My company has a matching gift program. A matching gift form is enclosed.

(Use NWACC Foundation Tax I.D. XX- XXXXXXX)

I am a

___ Graduate of NWACC: Grad Year _______ Major ____________

Employer ______________________________________

___ Former Student

___ Friend

After completing this form, send along with your payment to:

NorthWest Arkansas Community College Foundation

One College Drive

Bentonville , AR 72712

Call (479) 619-4184 for more information

*The NWACC Foundation also accepts gifts of trusts, bequests, annuities, securities, insurance, real estate and equipment. New endowed funds may be established and named at $10,000 and up. The NWACC Foundation is a 501(c)(3) tax-exempt organization.

For questions/comments on this content, please call 479-619-4184.

This page was last updated on:  December 21, 2009 @ 8:51 am