Carolinas Golf Association

Today's Date

- Month - Day Year

Names(s) of Donor:*

Mailing Address:*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail:*

Home Phone:*

- Area Code Phone Number

Work Phone:

- Area Code Phone Number

Cell Phone:

- Area Code Phone Number

I/We pledge the total amount of:*

ex. $10,000.00

To be paid over the following time period:*

Select 1-5 years

Divided into the following payments:*

Annually, Semi-Annually, Quarterly

Payment Start Date:*

- Month - Day Year

If this donation and pledge is reserving a naming opportunity, use the following name(s) on such item:

Payments over $5000.00 cannot be charged on a credit card. Please contact the CGA office at 910-673-1000 for payment options.

Agreement:*

By checking this box,I/We agree to fulfill our committment to the Carolinas Golf Association's "Setting the Course" capital campaign. A confirmation email will be sent to the address listed above.