Pledge of Support
I would like to make the following one time donation to New London Main Street:
__$2,500
__$1,000
__$500
__$250
__$100
__$50
_____other amount
__I would like to repeat my donation ____monthly ____quarterly ____annually.
Method of Payment:
__Enclosed is my check made payable to New London Main Street
mail to 147 State Street, Suite B, New London CT 06320
__Please charge $_________ to my: __Visa __MasterCard __American Express
____________________________________
Account Number
___________________
Expiration Date
_________________________________________________________
Signature
Please fill out completely:
Name:________________________________________________
Address:______________________________________________
City:_______________________State: _____Zip:____________
Telephone:________________________________________________________
Email Address:_____________________________________________________
___My employer will match my gift
___Please recognize my gift anonymously
___I require a hard copy acknowledgement mailed to the address above
New London Main Street is a 501 (c)(3) non-profit corporation and contributions are
tax-deductible to the fullest extent of the law (EIN: 06-1519618).
Thank you for your support!