Building Campaign Pledge Form

indicates a required answer

1. *	Donor Name(s)

2. *	Street Address

3. *	City/State/Zip

4.	Phone

5. *	Email

6. *	Total Amount of Pledge $

7. *

Pledge to be paid as follows

One-time donation now		One-time donation in the future
Repeating donation

8.	If in the future, please enter a date

9.	If repeating, please select a recurring option

10.	Additional comments

Please make checks payable to "Sioux Center URC Building Fund"

Send checks to:
Sioux Center URC
Attn: Treasurer
744 North Main Ave
Sioux Center, IA 51250