donation form 2016
TRANSCRIPT
8/18/2019 Donation Form 2016
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DONATION FORM
The Fields For Our Future, Inc. committee would greatly appreciate and strongly encourage your generoussupport of the Pella Sports Park Project .
Financial contributions to this project can be made a variety of ways, and over a time span of up to 5 years.Commitments reaching certain amounts are eligible for certain types of recognition, as noted below. To ll out thisform, please ll in the white boxes in the tables below. Please enter your contact information below:
E-MAIL: [email protected] • WWW.FACEBOOK.COM/PELLASPORTSPARK
PELLA SPORTS PARK PROJECTBUILDING COMMUNITY THROUGH SPORTS
To donate, please send this completed form, along with your rst payment (if desired) to this address:
Fields For Our Future, Inc.Attn: Pella Sports Park ProjectP.O. Box 838Pella, IA 50219
Checks can be made out to “Fields For Our Future, Inc”.
Fields For Our Future, Inc. is a 501(c)(3) non-prot corporationand charitable donations are tax deductable as allowed by law.
We may be publishing a donor list with levels of giving. Please check if you do not wish to be listed.
DONATION TOTALAMOUNT 2016 2017 2018 2019 2020 RECOGNITIO
LEVEL*
$25,000 $5,000 $5,000 $5,000 $5,000 $5,000 Platinum**
$10,000 $2,000 $2,000 $2,000 $2,000 $2,000 Platinum
$5,000 $1,000 $1,000 $1,000 $1,000 $1,000 Gold
$2,500 $500 $500 $500 $500 $500 Silver
$1,000 $200 $200 $200 $200 $200 Bronze
WRITE IN See Above
SignatureDo you intend to submit a “matchingfunds request to your employer?If “yes,” who is your employer?_____________________________
YES
NO
NAME ADDRESS CITY ZIP CODE
PHONE NUMBER E-MAIL ADDRESS
* Recognition Levels will be listed by donor name and displayed on a plaque at the facility.** Naming Rights are available for donations of $25,000+ (please email us for details).