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Pledge form

The Providence Black Repertory depends on generous supporters like you for our continued existence. We thank you in advance for your gift.

This form may be used for a pledge confirmation. For a printable PDF version of the form, which may be mailed or faxed to the Black Rep, click here.

Required items are indicated with an asterisk (*).

Section 1: Donor Information
Name:*
Address:*
 
City, State, Zip:*
Phone:*
E-mail:
Section 2: Pledge Information
This gift to be completed by
Please send reminders: annually
semi-annually
quarterly
monthly
My/our gift will be matched by:
(Learn more about Matching Gifts)
Section 3: Your Gift
Amount of your gift:*

$5,000
$2,500
$1,000
$500

 $250
$100
$50
Other:
Designation:*
(Please contact the PBRC for specific capital gift requirements.)

Unrestricted/Operating Support
Education/Workshops
Theater Productions — specify:
Raise the Roof Fund
Annual Contributors Fund
Matinee Host Fund
Further comments or specifications:

   
Section 4: Giving Opportunities
I/we would like to receive additional information regarding: Bequests
Gifts of Appreciated Assets
Charitable Trusts or Annuities
Named Endowment Funds
Facilities
Gifts of Tangible Personal Property
Is the PBRC in your will or other testamentary plans? Yes
No
Would consider
When you have entered all necessary information, click to submit your pledge: