North Bay's Family of Rotary Splash Pad Pledge/Donation Form
This form is provided for businesses, organizations, and individuals that wish to make a pledge towards the project. Donations can be split over 2 years (2019, 2020). Donors of $5,000, or more, have the opportunity to be named on the Donor Board.
* Required
YES, I am interested in becoming a Donor by...
*
Making a 1-time donation of $5,000 in 2019.
Making a 1-time donation of $5,000 in 2020.
Making a split donation of $5,000 over 2 years (2019, 2020).
Making a donation of $5,000 using Securities [stocks, mutual funds, bonds, etc.].
Making a donation of another amount. Please specify the amount in #2.
Other:
Required
Amount you wish to donate?
If not specified above.
Your answer
Method of Payment
*
Online.
www.rotarymakeasplash.com
Interac e-Transfer. Via your online banking and send to Recipient: Rotary Club of North Bay Email:
rotaryclubofnorthbay@icloud.com
Message Box: Please state donation is for Splash Pad.
Cheque. Payable to "Rotary Club of North Bay" PO Box 242, North Bay ON P1B 2H8. Please specify 'Rotary Splash Pad' on memo line.
Other:
NAME:
*
Business, Organization or Individual Name.
Your answer
Address:
Your answer
E-MAIL (best way for us to stay connected):
Your answer
Do you wish to have your name or that of your business/organization displayed on the Donor Board (donations $5,000 or more), website and other communications?
*
Yes
No
North Bay's Family of Rotary thanks you for your generous support!
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