CLIP Pledge Donation Form 2021-2022
Recommended Donation:
Kindergarten - 5th grade families: $425 per child
6th - 8th grade families: $200 per child

Please pledge the recommended amount for the 2021-2022 academic year. You can fulfill your pledge by paying the full amount.

Corporate matching dollars are considered an addition to the recommended donation.

Payment options will be available once you submit this form.
Parent/Guardian
First Name *
Last Name *
Phone Number *
Email Address *
The donation receipt will be sent to this email address.
Child
First Name *
Middle Initial
Last Name *
Grade/Room *
Donation Amount *
Recommended Donation: $425 (Grades K to 5), $200 (Grades 6 to 8)
Do you have another child in the CLIP program? *
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