Thursday, 07 January 2016 14:57


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PLEDGE FORM:  Victoria General Hospital Auxiliary’s Oasis Campaign


Individual Giving

Your Name:___________________________________________

Home Address:________________________________________

Phone Number:________________________________________



Corporate Giving

Company Name:_______________________________________


Your Position:_________________________________________

Key Company Contacts:_________________________________

Preferred Email:_______________________________________


Pledge Information

Pledge Amount Minimum: $________________

Pledge for Contract Value: $_______________

Describe Your Commitment:_________________________________________________________


Your gift is due on May 1, payable by cheque to the VGH Auxiliary and sent to the Auxiliary at Victoria General Hospital. Pledges made after this date will be due and payable on the first day of the ensuing month.


Payment Method:

 Master Card    




Name on Card:__________________________________________

Credit Card Number:_____________________________________ 

Expiration Date:_________


Issue receipt in the name of:______________________________


 I/we prefer this gift to remain anonymous

 I/we wish to be recognized as _____________________________________________


Notes or comments:_____________________________________________________________


Everyone using the Oasis thanks you for making this project possible.

Read 3504 times Last modified on Sunday, 10 January 2016 10:20
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