Capital Campaign Commitment Form

Name(s)*

First Last

I am sharing my commitment with another member.*

Yes
No

If yes, please add their name:

First Last Suffix

Your Address:*

Street Address Address Line 2 City State ZIP Code

Phone(s):*

Email(s):*

Total Amount of Embracing Our Future Campaign Commitment*

I/We would like my name/our names to be included in the list of donors for First UU Embracing Our Future. (Only your names will be used; commitment amounts are kept confidential.)

Yes
No

I/We would like more information about including First UU in my/our estate plans.

Yes
No

I/We would like to make this commitment in honor or memory of another person(s)

Yes
No

In honor of:

In memory of:

Frequency of commitment:*

Monthly (between now and December 30, 2023)
Semi-Monthly (between now and December 30, 2023)
Bi-Weekly (26 payments per fiscal year)
Quarterly (January 1, 2022-December 30, 2023)
Annual (by 12/2021; 12/2022; 12/2023)
Other

Payment Method:*

check
bank debit
credit card
stock transfer/other

Comments or Notes here:

Click here to set up on-line Debit/Credit payment(s)

Phone

This field is for validation purposes and should be left unchanged.

Location

Accessibility

Hours

First Unitarian Universalist RVA

Sunday Service: 10am