1. PLEDGE AMOUNT

$250        $500       $1,000     Other (please specify amount)

$2,500     $5,000     $10,000    $   A value is required.  

 

2. PAYMENT SCHEDULE

Single Payment - One Time Gift

Quarterly Gift (The above pledge amount will be divided into 4 equal payments)

Semi-Annually Basis (The above pledge amount will be divided into 2 equal payments)

 

3. GIFT DESIGNATION

This gift is in honor/memory of:
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Use my gift:

Where the need is greatest

Other (please specify):
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4. YOUR BILLING INFORMATION

First Name
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Last Name
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Address
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City
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State
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Zip
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Daytime phone
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E-mail Address
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5. PAYMENT METHOD

Visa           Mastercard          American Express

Credit card account No.:
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Expiration:
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Please send me information on naming Mercy in my will.

You have one more screen to confirm your gift contribution.