Be Our Best Pledge Form

First Name

Last Name

Company (If applicable)

Address

City

Zip

I/We are pleased to offer the following support to the Springfield Jewish Community Center:

Total gift amount to Be Our Best:

I would like to pay this amount now:

The rest of the balance will be paid over how many years?

Please list the dates and amounts that you would like to be charged:

Method of Payment

Check (payable to Springfield Jewish Community Center 1160 Dickinson Street Springfield MA 01108) Transfer of Securities: Springfield Jewish Community Center staff will provide special instructions. Credit Card or Automatic Payment: Springfield Jewish Community Center will contact you My gift may qualify for corporate matching from my company. Other method/ Special instruction

If you selected Other method/ Special instruction please specify:

Recognition:

Name(s) as you wish to be listed:

Please list my gift as anonymous.

This gift is in honor/memory of (if applicable):

Please contact me to discuss options for including the Springfield JCC in my estate planning, including planned giving bequests and wills.

I/We understand that our gift is tax deductible to the extent of the law.

I/We understand that the Springfield Jewish Community Center will rely on this pledge in making commitments for expenditures, borrowing, constructions projects and other commitments.

Date

By my signature above, I pledge to fulfill this commitment according to the payment schedule shown. I understand that I may prepay this amount at any time. If my commitment involves a Naming Opportunity, I understand that there will be a separate Gift Agreement to supplement this signed commitment form.

I/We are pleased to offer the following support to the Springfield Jewish Community Center:

Recognition:

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