Abilene Junior Academy Sponsorship Agreement Date: __ __/__ __/__ __ __ __ Donor Name: ___________________________________________________ Billing Address: _________________________________________________ City, St., Zip Code: ______________________________________________ Phone: ________________________________________________________ Email: ________________________________________________________ Pledge info I (we) pledge a total of $__________to be paid: □ monthly for one year □ monthly for two years □ monthly for three years □ one time I(we) plan to make this contribution in the form of □ cash □ check □ other: __________________________ □ credit card (this selection authorizes AJA to charge according to selections made on this form) Credit Card Information □ Visa □ Discover □ Mastercard CC number: ___________________________________________ ___ Expiration Date: ____________________ Security code: ___________ Authorization signature: _____________________________________ □I (we) wish to have our gift to remain anonymous Signature: Date: ____________________________________ __________________ Please make checks payable to Abilene Junior Academy 2542 E. Overland Trl. Abilene, TX 79601 Thank you for your tax-exempt donation! Office use □ Donation received □ Tax exempt receipt sent __________________________________________________________________________________________________
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