Masjid Pledge Form
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Pledge Form Donor Information (please print or type) Name Billing address City State ZIP Code Telephone (home) Telephone (business) Fax E-Mail Pledge Information I (we) pledge a total of $to be paid: now monthly quarterly yearly. I (we) plan to make this contribution in the form of: cash check other. Donation will be matched by (company/family/foundation). form enclosed form will be forwarded Acknowledgement Information Please use the following name(s) in all acknowledgements:
I (we) wish to have our Donation remain anonymous. Signature(s)
Date Please make checks, corporate matches, or other Donation payable to: PURAN WELFARE SOCIETY INC. 3033 YOUNG AVENUE BRONX, N.Y. 10469
I (we) wish to have our Donation remain anonymous. Signature(s)
Date Please make checks, corporate matches, or other Donation payable to: PURAN WELFARE SOCIETY INC. 3033 YOUNG AVENUE BRONX, N.Y. 10469
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