2018 pledge form
2018 PLEDGE FORM UNI Financial Services, 121 Commons, Cedar Falls, IA 50614-0239 (319) 273-2471 www.unipanthers.com/invest STEP 1: Fill in Contact Information Circle One New OR Renewal
Circle One Individual OR Buisness
Membership Name: ___________________________________________________ Contact Name: _______________________________________________________ Address:____________________________________________________________ City: ___________________________________________ State: ___ Zip:________ Phone:____________________ (H) (C) (B) Phone:___________________ (H) (C) (B) Email:______________________________________________________________ Publication Listing (i.e. Football Program Listing): ___________________________ Volunteer Contact: ____________________________________________________ STEP 2: Check Special Benefits... UNI Employee: __ __ __ __ __ __ Under 30 (DOB): _____________ *If you are under 30 and/or a UNI Employee your total giving will be ghost matched for potential level increase*
STEP 3: Insert Gift-In-Kind Amount
Contribution Levels Leadership - $25,000 + Platinum - $13,000 - $24,999 Diamond - $8,000 - $12,999 Scholarship - $4,100 - $7,999 UNI Pride - $3,000 - $4,099 VIP - $2,100 - $2,999 Directors - $1,600 - $2,099 Gold - $1,200 - $1,599 Purple - $600 - $1,199 Coaches - $350 - $599 Loyalty - $25 - $349
Company Name: _____________ Company Match: $ ___________ Please attach form to be submitted with your payment
...
(if applicable)
Service: _____________________________________________________________________________________________________________ Amount: $ ___________ (Must be preapproved by PSC Staff & be accompanied w/minimum of $200 cash.)
STEP 4: Insert Cash Amount... Amount: $ ___________
STEP 5: Select Payment Method... BILL ME: Please send a reminder_____________
CHECK/CASH ENCLOSED: $ ______ Payable to: Panther Scholarship Club
CREDIT CARD: Please charge my card $______ ___one time ___monthly ___quarterly beginning (mm/yr) ___/___ Please complete credit card information at bottom
(Member will not receive benefits until paid in full)
UNI PAYROLL DEDUCT: Please deduct $___ per month Beginning (mm/yy) ___/___ (Payable in full by 12/31/18) University ID __ __ __ __ __ __ Employee Status: 10 mo OR 12 mo
AUTOMATIC MONTHLY PAYMENT Debit $_____ per month on ____ (day of month) Beginning (mm/yy) ___/___
A voided check is attached. I heareby authorize the UNI foundation to initiate debit entries to my account. The authority is to remain in full force until I notify the UNI Foundaiton of termination. Thirty days notice is required.
STEP 6: Add Total Giving... Total Cash & Gift In Kind: $_______________________________
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‘Momentum Club” (increase level)
STEP 7: Fill In Membership Level for 2018 2018 Membership Level: __________________________________ STEP 8: Sign! Signature (Required):___________________________________________________ Date:_________________ STEP 9: Credit Card Information (if applicable) Charge my (Circle One): VISA MasterCard Discover
American Express
Card #:______________________________________________________ Exp. Date:________ CREDIT CARD INFORMATION WILL NOT BE KEPT ON FILE.
THANK YOU FOR YOUR CONTINUED SUPPORT! Your contribution provides our student-athletes with the resources necessary to perform at the highest level in the classroom and in competition.
2018 BENEFIT CHART
IMPORTANT MCLEOD RESEAT INFORMATION At least ONE Payment MUST be made on your 2018 PSC pledge and 2018-19 Men’s Basketball Season Tickets prior to June 30, 2018 in order for donor to be eligible for 2018-2019 Men’s Basketball Reseat. In return, as a member of the Panther Scholarship Club you will receive tax deductibility (as allowed by tax laws) and benefits. If you have questions regarding benefits please contact the Panther Scholarship Club at (319) 273-2471
Circle One Individual OR Buisness
Membership Name: ___________________________________________________ Contact Name: _______________________________________________________ Address:____________________________________________________________ City: ___________________________________________ State: ___ Zip:________ Phone:____________________ (H) (C) (B) Phone:___________________ (H) (C) (B) Email:______________________________________________________________ Publication Listing (i.e. Football Program Listing): ___________________________ Volunteer Contact: ____________________________________________________ STEP 2: Check Special Benefits... UNI Employee: __ __ __ __ __ __ Under 30 (DOB): _____________ *If you are under 30 and/or a UNI Employee your total giving will be ghost matched for potential level increase*
STEP 3: Insert Gift-In-Kind Amount
Contribution Levels Leadership - $25,000 + Platinum - $13,000 - $24,999 Diamond - $8,000 - $12,999 Scholarship - $4,100 - $7,999 UNI Pride - $3,000 - $4,099 VIP - $2,100 - $2,999 Directors - $1,600 - $2,099 Gold - $1,200 - $1,599 Purple - $600 - $1,199 Coaches - $350 - $599 Loyalty - $25 - $349
Company Name: _____________ Company Match: $ ___________ Please attach form to be submitted with your payment
...
(if applicable)
Service: _____________________________________________________________________________________________________________ Amount: $ ___________ (Must be preapproved by PSC Staff & be accompanied w/minimum of $200 cash.)
STEP 4: Insert Cash Amount... Amount: $ ___________
STEP 5: Select Payment Method... BILL ME: Please send a reminder_____________
CHECK/CASH ENCLOSED: $ ______ Payable to: Panther Scholarship Club
CREDIT CARD: Please charge my card $______ ___one time ___monthly ___quarterly beginning (mm/yr) ___/___ Please complete credit card information at bottom
(Member will not receive benefits until paid in full)
UNI PAYROLL DEDUCT: Please deduct $___ per month Beginning (mm/yy) ___/___ (Payable in full by 12/31/18) University ID __ __ __ __ __ __ Employee Status: 10 mo OR 12 mo
AUTOMATIC MONTHLY PAYMENT Debit $_____ per month on ____ (day of month) Beginning (mm/yy) ___/___
A voided check is attached. I heareby authorize the UNI foundation to initiate debit entries to my account. The authority is to remain in full force until I notify the UNI Foundaiton of termination. Thirty days notice is required.
STEP 6: Add Total Giving... Total Cash & Gift In Kind: $_______________________________
100062 / 220001 - 21
‘Momentum Club” (increase level)
STEP 7: Fill In Membership Level for 2018 2018 Membership Level: __________________________________ STEP 8: Sign! Signature (Required):___________________________________________________ Date:_________________ STEP 9: Credit Card Information (if applicable) Charge my (Circle One): VISA MasterCard Discover
American Express
Card #:______________________________________________________ Exp. Date:________ CREDIT CARD INFORMATION WILL NOT BE KEPT ON FILE.
THANK YOU FOR YOUR CONTINUED SUPPORT! Your contribution provides our student-athletes with the resources necessary to perform at the highest level in the classroom and in competition.
2018 BENEFIT CHART
IMPORTANT MCLEOD RESEAT INFORMATION At least ONE Payment MUST be made on your 2018 PSC pledge and 2018-19 Men’s Basketball Season Tickets prior to June 30, 2018 in order for donor to be eligible for 2018-2019 Men’s Basketball Reseat. In return, as a member of the Panther Scholarship Club you will receive tax deductibility (as allowed by tax laws) and benefits. If you have questions regarding benefits please contact the Panther Scholarship Club at (319) 273-2471
