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The Village People of West Salem - "Presenting West Salem" Pledge Form...

 

PRINT OUT THIS PAGE AND MAIL YOUR CONTRIBUTION TODAY!
Keep a copy of this form for your records for tax deductible purposes, as we are a 501c3 entity.
Amount Pledged:

Name:

Business:

Address:

City:

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ZIP:

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Signature:

Enclosed is my/our contribution of:

I/we wish to pledge this amount:
Monthly Yearly

I am interested in auto withdrawal from my bank. Please contact me:
I wish to remain anonymous.
I wish to volunteer my time in this effort.

Please make checks payable to:
The Village People of West Salem
P.O. Box 10
West Salem, WI 54669
Thank You for your support!