Pledge And Acknowledgement Form - Arkansas Pi Beta Phi (Page 2 of 2) in pdf

Pledge And Acknowledgement Form - Arkansas Pi Beta Phi Page 2

We encourage you to include the Chapter and Initiation Year of all members of Pi Beta Phi to be listed. In addition, if

anyone served as Chapter president, please include that information along with the year served. Members of all Pi Phi

Chapters are welcome to be recognized (with the exception of Chapter Room Chairs which are reserved for Arkansas

Alpha members only).

_____ I have enclosed a check for my total made payable to

The Arkansas Alpha Chapter House

Corporation.

_____ Please charge my credit card for my total payment due

(a 2% processing fee will apply)

If paying by credit or debit card, please include the following information:

Visa

MasterCard

Discover

Amex

Name_____________________________________________________________________________________________

Card Number__________________________________ Expiration Date_______________ Security Code____________

Billing Address _____________________________________________________________________________________

Total Amount To Be Charged Including 2% Processing Fee $________________

Signature___________________________________________________ Date___________________________________

____ Please bill me in four equal installments (due in 2017, 2018 and 2019)

Please note that all pledges must be paid in full by December 31, 2019.

Please Return this form to:

Pi Beta Phi - The Second Century Campaign

c/o: Misty McIlroy Hawkins, Co-Chair

5240 Edgewood Road | Little Rock, Arkansas 72207

For information about larger donations ($3,141.59 and above) that qualify for tax deductible giving,

please contact Misty McIlroy Hawkins at 501-666-7474 or mhawkins@aristotle.net

Building

ur Legacy

The Second Century Campaign

Pledge And Acknowledgement Form - Arkansas Pi Beta Phi Page 2