Invoice Me Pledge Form

Your pledge will measurably improve the lives of vulnerable children, individuals and families in Hancock County. Your donation will go to work right here in our community. Please fill out this online pledge form and we'll invoice you per your request. If you prefer to make a one-time or recurring donation via credit card, please click here.

How would you like to be addressed?

Full Name

First Name

Last Name

Home Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Personal Phone

Work Phone

Employer

Employee Identification Number (optional)

Would you like us to set up a payroll deduct pledge through your employer?

Yes

Invoice Me (Select how much you'd like to pledge, as well as the time period in which you'd like to donate through)

Total Annual Pledge $ Amount

How would you like to split your annual pledge payments?

Monthly

Quarterly

Annually

When would you like to start your pledge payments?

When would you like your pledge to be completed by? (end date)

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

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