Three Year Pledge - Scotch Oakburn College Launceston Tasmania

I/we would like to support the Scotch Oakburn Centre for Science and Mathematics by making a three-year pledge to the Scotch Oakburn Foundation Building Fund (which has tax deductible status).

Name (Person 1)*

First Last

Name (Person 2)

First Last

Address*

Street Address Address Line 2 City State Postcode Country

Phone

Email

Enter Email Confirm Email

I/we, the above named, undertake to the Scotch Oakburn Foundation that I/we will give the Scotch Oakburn Foundation Building Fund - Centre for Science and Mathematics Campaign the following:

Instalment options

I/we will make three equal instalments over three years
I/we will make three different instalments each year over three years

Amount of each instalment

Please enter the amounts you wish to pledge each year below:

Year 1 - paid now

Year 2

Year 3

Donor Recogntion

I/we would like my/our donation to remain anonymous
Please record my/our gift (not the amount) in the published list of donors

Please provide the format in which you would like your name/s recorded on the published donor list.

Payment Options

I/we will be making donations by*

Cheque
Credit Card
Direct Debit Authorisation

Cheque

Please make cheques out to Scotch Oakburn College Foundation Building Fund and send to:

Foundation Office
Scotch Oakburn College
Locked Bag 103
KINGS MEADOWS TAS 7249

Direct Debit Authorisation

I/we authorise the following Direct Debit from my/our account

Annual
Monthly (annual pledge divided into 12 equal payments)

Account Name

BSB

Account No

Bank

Credit Card

On submitting your pledge form you will be directed to our secure Paypal payment page complete your pledge. Your card will then be automatically charged your pledge amount at the same time in the next 2 years.

On submitting your pledge form you will be directed to our secure Paypal payment page to complete your first year's pledge. You will then be contacted in future years to confirm credit card payments for subsequent pledges.

Total to be charged to your credit card today

Price: $ 0.00

Statement

By entering my name in the field provided below you confirm that this form accurately records your pledge to the Scotch Oakburn College Foundation Building Fund.

Name of person completing form*

Date of completion*