Pledge Form

My Personal Information:

Name as I wish it to appear in acknowledgements: *
 
Winter (primary) address:   Summer address:

Street/PO Box:

*    
City:
*    
State/Region:
*    
Zip/Postal Code:
*    
Country:
*    
         
Phone:
*    
From:  Through: 
From:  Through: 
       
Email Address

:

*


My Pledge:

I pledge to support the Unitarian Universalist Church on Nantucket Island during:
     
I would like to make my pledge in the following manner:*
     
Weekly (x 52)
  Monthly (x12)
  Quarterly (x 4)
  Once
 
 
For a total pledge of $


My Payment Information:


  I wish to pay by check or cash.
    Please send offering envelopes
    Please make checks payable to: Nantucket Unitarian Church
     
  I wish to pay my total pledge online now via credit card.
     
  If you would like to have your credit card charged periodically, select this option and someone will contact you. ( Do not fill in your Credit Card information if you choose this option. )
     

My Credit Card Information:

Name as it appears on credit card

:

*
     
Billing Address
:
Same as Winter (Primary) Address
Street/PO Box:
:
*
City
:
*
State/Region
:
*
Zip/Postal Code
:
*
Country
:
*
Phone
:
*
Type of Card :  
MasterCard Visa American Express *
Card Number :  
*
CVV Code :  
*
Expiration Date :
 Month : *   Year : *
   
Validation Code:   CAPTCHA Image   *  Load new Image
     
Please enter the Validation Code Here: *
 
* = Required Fields



The Unitarian Universalist Church on Nantucket is a 501(c)(3) not-for-profit corporation. Contributions are deductible to the full extent of applicable tax regulations.  Advice from your tax and legal advisors is recommended.