USC FOUNDATION: Donor Pledge Form

While we are awaiting confirmation of charitable status, please complete the following, should you wish to make a commitment to donate.

DONOR NAME (Name of Individual or Organization):
DONOR ADDRESS: DONOR ADDRESS:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
CONTACT NAME (If donor is not an individual) CONTACT NAME (If donor is not an individual) First Last
CONTACT TELEPHONE: CONTACT TELEPHONE: - ### - ### ####
CONTACT EMAIL:
DONATION PLEDGE

DONATION PLEDGE Upon being notified of the registration of the USC Foundation as a Canadian charitable foundation, the undersigned hereby pledges and commits to make a one-time donation Upon being notified of the registration of the USC Foundation as a Canadian charitable foundation, the undersigned hereby pledges and commits to make an annual donation of
Donation Amount
Number of Years
Total Donation Amount
Dated Dated / MM / DD YYYY
Signing on behalf of...

Signing on behalf of... Individual Organization
Name of Individual Name of Individual First Last
Signature of Individual

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Name of Signing Officer Name of Signing Officer First Last
Signature of Authorized Signing Officer

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.