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Pledge
Form
Hindu Temple of Southwest
Florida
PO Box 60845
Fort Myers, FL 33906
(239) 482-0677
Name
_____________________________
Address____________________________
__________________________________
Phone______________________________
Email______________________________
I pledge to support the Hindu Temple of Southwest
Florida
and its activities.
Check appropriate amount.
Individual
Family
Trustee
___$10,000
__$20,000
Yearly Membership Jan 1st
– Dec 31st, 2005
Patron
___$500
___$1000
Associate
___$100
___$200
I am donating ________ to the Temple.
I will volunteer my time for Temple activities and
committees _______________
I authorize Hindu
Temple of
Southwest Florida to debit my Credit Card/Bank Acct
__________________________________
for an amount of
$_______ per month.
Signature_____________________
Date _______________
All contributions are
tax deductible.
May Ganesha bless you for your generous contribution!
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